Resuscitation in acute traumatic coagulopathy
There has been a marked shift in the practice of trauma
resuscitation over the last decade, towards damage control
resuscitation following the changes in our understanding of
acute traumatic coagulopathy. Damage control resuscitation
employs multiple strategies to combat hypothermia, acidosis,
hypoperfusion and coagulopathy. Techniques include active
rewarming, restricting fluid administration, aggressive early
blood products administration in an effort to prevent and limit
acute traumatic coagulopathy. Various recommendations
have been published in recent times for the management of
coagulopathy of trauma. Most of them emphasize on assessment
of shock and tissue hypoperfusion, rapid detection and
quantification of coagulopathy, and damage control resuscitation.
We propose the following steps of damage control
resuscitation for prevention and treatment of acute traumatic
coagulopathy which is the result of experience gained in the
last decade and based on recent evidences. Recommendations
were formulated and graded according to the grading of recommendations
assessment, development and evaluation
(GRADE) hierarchy of evidence