| Acute coagulopathy of trauma: mechanism, identification and effect. | |
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MedLine Citation:
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PMID: 17975390 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Acute coagulopathy of trauma has only been described relatively recently. Developing early in the postinjury phase, it is associated with increased transfusion requirements and poor outcomes. This review examines the possible initiators, mechanism and clinical importance of acute coagulopathy. RECENT FINDINGS: Acute coagulopathy of trauma occurs in patients with shock and is characterized by a systemic anticoagulation and hyperfibrinolysis. Dilution, acidemia and consumption of coagulation proteases do not appear to be significant factors at this stage. There is evidence to implicate activation of the protein C pathway in this process. Diagnosis of acute coagulopathy currently relies on laboratory assessment of clotting times. These tests do not fully characterize the coagulopathy and have significant limitations, which reduce their clinical utility. SUMMARY: Acute coagulopathy results in increased transfusion requirements, incidence of organ dysfunction, critical care stay and mortality. Recognition of an early coagulopathic state has implications for the care of shocked patients and the management of massive transfusion. Identification of novel mechanisms for traumatic coagulopathy may lead to new avenues for drug discovery and therapeutic intervention. |
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Authors:
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Karim Brohi; Mitchell J Cohen; Ross A Davenport |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in critical care Volume: 13 ISSN: 1070-5295 ISO Abbreviation: Curr Opin Crit Care Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-02 Completed Date: 2008-02-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504454 Medline TA: Curr Opin Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 680-5 Citation Subset: IM |
Affiliation:
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Department of Surgery, The Royal London Hospital, London, UK. karim@trauma.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Blood Coagulation Blood Coagulation Disorders / diagnosis, etiology*, physiopathology Blood Coagulation Tests Blood Transfusion Fibrinolysis Humans Injury Severity Score Protein C Risk Factors Shock / complications* Wounds and Injuries / complications* |
| Chemical | |
Reg. No./Substance:
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0/Protein C |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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