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Trauma-associated hyperfibrinolysis.

Abstract
Trauma-induced coagulopathy (TIC) has been considered for a long time as being due to depletion of coagulation factors secondary to blood loss, dilution and consumption. Dysfunction of the remaining coagulation factors due to hypothermia and acidosis is assumed to additionally contribute to TIC. Recent data suggest that hyperfibrinolysis (HF) represents an additional important confounder to the disturbed coagulation process. Severe shock and major tissue trauma are the main drivers of this HF. The incidence of HF is still speculative. According to visco-elastic testing of trauma patients upon emergency room admission, HF is present in approximately 2.5-7% of all trauma patients. However, visco-elastic tests provide information on severe forms of HF only. Occult HF seems to be much more common but diagnosis is still challenging. Results from a recent randomized, placebo-controlled trial suggest that the early treatment of trauma patients with tranexamic acid may result in a significant reduction of trauma-associated mortality.
AuthorsH Schöchl, W Voelckel, M Maegele, C Solomon
JournalHämostaseologie (Hamostaseologie) Vol. 32 Issue 1 Pg. 22-7 ( 2012) ISSN: 0720-9355 [Print] Germany
PMID22009115 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Blood Coagulation Disorders (mortality)
  • Causality
  • Comorbidity
  • Evidence-Based Medicine
  • Germany (epidemiology)
  • Humans
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Wounds and Injuries (mortality)

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