a b s t r a c t
Transfusion and resuscitation practices in trauma have undergone a sea change over the
past decade. New understanding of transfusion physiology and experiences in military
trauma over the last decade has identified key factors taken as challenges in trauma. The
most important challenge remains acute traumatic coagulopathy (ATC) which sets in early
after a trauma and spirals the patient into shock and continued bleeding. World wide
trauma is the leading cause of mortality. More than 6 million deaths occur due to trauma
out of which 20% are due to uncontrollable bleeding. Out of the hospital admissions in
trauma 20% develop coagulopathy. Mortality is three to four times higher in a patient with
coagulopathy and thus prevention and correction of coagulopathy is the central goal of the
management of hemorrhagic shock in trauma. Damage control resuscitation (DCR), a
strategy combining the techniques of permissive hypotension, hemostatic resuscitation
and damage control surgery has been widely adopted as the preferred method of resuscitation in patients with haemorrhagic shock. The over-riding goals of DCR are to mitigate metabolic acidosis, hypothermia and coagulopathy, This article looks at the importance of acute traumatic coagulopathy, its etiology, diagnosis, effects and resuscitation strategies to prevent it and to see the background behind this shift. 2014, Armed Forces Medical Services (AFMS). All rights reserved.
a b s t r a c tTransfusion and resuscitation practices in trauma have undergone a sea change over thepast decade. New understanding of transfusion physiology and experiences in militarytrauma over the last decade has identified key factors taken as challenges in trauma. Themost important challenge remains acute traumatic coagulopathy (ATC) which sets in earlyafter a trauma and spirals the patient into shock and continued bleeding. World widetrauma is the leading cause of mortality. More than 6 million deaths occur due to traumaout of which 20% are due to uncontrollable bleeding. Out of the hospital admissions intrauma 20% develop coagulopathy. Mortality is three to four times higher in a patient withcoagulopathy and thus prevention and correction of coagulopathy is the central goal of themanagement of hemorrhagic shock in trauma. Damage control resuscitation (DCR), astrategy combining the techniques of permissive hypotension, hemostatic resuscitationand damage control surgery has been widely adopted as the preferred method of resuscitation in patients with haemorrhagic shock. The over-riding goals of DCR are to mitigate metabolic acidosis, hypothermia and coagulopathy, This article looks at the importance of acute traumatic coagulopathy, its etiology, diagnosis, effects and resuscitation strategies to prevent it and to see the background behind this shift. 2014, Armed Forces Medical Services (AFMS). All rights reserved.
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