| Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing |
| Marc Maegele1,2 |
1Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), Witten/Herdecke University, Cologne, Germany
2Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany |
| Correspondence
Marc Maegele Tel: +49 (0)221 89 07 13 614, Fax: +49 (0)221 89 07 30 85, Email: Marc.Maegele@t-online.de |
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Received: February 7, 2024. Accepted: February 20, 2024. Published online: March 15, 2024. |
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| ABSTRACT |
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Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are the two predominant causes of preventable death after trauma. Early control of bleeding sources and rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of hemorrhage and TIC from acute trauma, even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC. |
| Keywords:
Trauma; Bleeding; Hemorrhage; Coagulopathy; Viscoelastic testing |
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