Coagulopathy and blood component transfusion in trauma

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Serval ID
serval:BIB_5DF07EF33D48
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Coagulopathy and blood component transfusion in trauma
Journal
British Journal of Anaesthesia
Author(s)
Spahn D.R., Rossaint R.
ISSN
0007-0912 (Print)
ISSN-L
0007-0912
Publication state
Published
Issued date
2005
Volume
95
Number
2
Pages
130-139
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Uncontrollable bleeding accounts for 39% of trauma-related deaths and is the leading cause of potentially preventable death in patients with major trauma. While bleeding from vascular injury can usually be repaired surgically, coagulopathy-related bleeding is often more difficult to manage and may also mask the site of vascular injury. The causes of coagulopathy in patients with severe trauma are multifactorial, including consumption and dilution of platelets and coagulation factors, as well as dysfunction of platelets and the coagulation system. The interplay between hypothermia, acidosis and progressive coagulopathy, referred to as the 'lethal triad', often results in exsanguination. Current management of coagulopathy-related bleeding is based on blood component replacement therapy. However, there is a limit on the level of haemostasis that can be restored by replacement therapy. In addition, there is evidence that transfusion of red blood cells immediately after injury increases the incidence of post-injury infection and multiple organ failure. Strategies to prevent significant coagulopathy and to control critical bleeding effectively in the presence of coagulopathy may decrease the requirement for blood transfusion, thereby improving clinical outcome of patients with major trauma.
Keywords
Blood Coagulation Disorders/complications, Blood Coagulation Disorders/therapy, Hemostatics/therapeutic use, Hypothermia/complications, Wounds and Injuries/complications, Wounds and Injuries/therapy
Pubmed
Web of science
Open Access
Yes
Create date
13/07/2018 10:00
Last modification date
01/10/2019 7:18
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