Open AccessMasivno krvavljenje i mehanizmi koagulopatije u traumi
Author(s) -
Nada Popović,
Z. Blagojević,
V.T. Nikolic,
L. Arsenijević,
Aleksandar Karamarković,
B Stefanović,
Zvezdana Kojić
Publication year - 2006
Publication title -
acta chirurgica iugoslavica
Language(s) - English
Resource type - Journals
eISSN - 2406-0887
pISSN - 0354-950X
DOI - 10.2298/aci0604089p
Subject(s) - coagulopathy , medicine , hyperfibrinolysis , hypothermia , major trauma , disseminated intravascular coagulation , intensive care medicine , acidosis , surgery , anesthesia
Trauma is disease of the young, mainly affecting people between 15-40 years of age. Uncontrolled massive bleeding is the leading cause of early in-hospital mortality, within 48h of admission, and the second leading cause of prehospital death in victims of both military and civilian trauma, accounting for 40-45% of the total fatalities. Coagulopathy develops early after injury and is present in 25- 36% of trauma victims upon admission to the emergency department. Coagulopathy correlates to the severity of trauma and is associated with an increased risk of mortality. The aim of this paper is to explain pathophysiology of developing coagulopathy in trauma. The coagulopathy in the trauma patient is complex and multifactorial. It includes: dilutional coagulopathy, hypothermia, acidosis, hyperfibrinolysis, anemia and consumption coagulopathy. When the patient develops the so called ?lethal triad? of hypothermia, acidosis and coagulopathy, surgical restoration of vascular integrity may be insufficient to achieve a definitive control of blood loss and non-mechanical bleeding from small vessels, usually terminated by spontaneous coagulation, becomes a life-threatening condition.