Skip Navigation LinksHome > September 2014 - Volume 21 - Issue 5 > Mechanisms of trauma-induced coagulopathy
Current Opinion in Hematology:
doi: 10.1097/MOH.0000000000000063
HEMOSTASIS AND THROMBOSIS: Edited by Joseph E. Italiano and Jorge A. Di Paola

Mechanisms of trauma-induced coagulopathy

Cardenas, Jessica C.; Wade, Charles E.; Holcomb, John B.

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Abstract

Purpose of review

Hemorrhage is the leading cause of potentially preventable death following injury. Excessive and uncontrolled bleeding, commonly referred to as trauma-induced coagulopathy (TIC), affects a quarter of all trauma patients and is associated with substantial injuries, increased transfusion requirements, and poor outcomes. Recent data have contributed to our current understanding of the molecular mechanisms driving TIC.

Recent findings

The current literature offers evidence supporting proposed mechanisms that induce TIC, such as platelet dysfunction, endogenous anticoagulation, endothelial activation, fibrinogen modifications, and hyperfibrinolysis. However, the majority of these data are mere associations; causative data are slowly unfolding through the utilization of animal models of hemorrhagic shock coupled with prospective observational clinical studies.

Summary

As both clinical and basic science research expands our understanding of TIC, trauma patient care is improving substantially. Future studies should focus on the interplay between the coagulation pathways whose simultaneous or codependent dysregulation could offer the most advantageous points for intervention.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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