Early and individualized goal-directed therapy for trauma-induced coagulopathy

Scand J Trauma Resusc Emerg Med. 2012 Feb 24;20:15. doi: 10.1186/1757-7241-20-15.

Abstract

Severe trauma-related bleeding is associated with high mortality. Standard coagulation tests provide limited information on the underlying coagulation disorder. Whole-blood viscoelastic tests such as rotational thromboelastometry or thrombelastography offer a more comprehensive insight into the coagulation process in trauma. The results are available within minutes and they provide information about the initiation of coagulation, the speed of clot formation, and the quality and stability of the clot. Viscoelastic tests have the potential to guide coagulation therapy according to the actual needs of each patient, reducing the risks of over- or under-transfusion. The concept of early, individualized and goal-directed therapy is explored in this review and the AUVA Trauma Hospital algorithm for managing trauma-induced coagulopathy is presented.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Algorithms
  • Anticoagulants / therapeutic use
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / physiopathology
  • Blood Coagulation Disorders / therapy*
  • Blood Viscosity
  • Fibrinogen / administration & dosage
  • Hemorrhage / therapy
  • Humans
  • Needs Assessment
  • Platelet Function Tests
  • Thrombelastography
  • Wounds and Injuries / complications

Substances

  • Anticoagulants
  • Fibrinogen