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Trauma remains a leading cause of death worldwide, and most early preventable deaths in both the civilian and military settings are due to uncontrolled hemorrhage, despite paradigm advances in modern trauma care. Combined tissue injury and shock result in hemostatic failure, which has been identified as a multi-dimensional molecular, physiologic, and clinical disorder termed trauma-induced coagulopathy (TIC). Understanding the biology of TIC is of utmost importance as it is often responsible for uncontrolled bleeding, organ failure, thromboembolic complications, and death. Investigations have exposed that TIC is characterized by multiple phenotypes of impaired hemostasis due to altered biology in clot formation and breakdown. These coagulopathies are attributable to tissue injury and shock and encompass underlying endothelial, immune, and inflammatory perturbations. Despite the recognition and identification multiple mechanisms and mediators of TIC and the development of targeted treatments, the mortality rates and associated morbidities due to hemorrhage after injury remain high. The purpose of this review is to examine the past and present understanding of the multiple distinct but highly integrated pathways implicated in TIC to highlight the current knowledge gaps and future needs in this evolving field, aimed at reducing morbidity and mortality after injury. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Journal of thrombosis and haemostasis : JTH
Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by a...
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The objetive of this study is to compare the treatment of two groups of politrauma patients that have fibrinogen deficiency (Fibtem < 9) diagnose by thromboelastography (ROTEM) but do not ...
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A stochastic process such that the conditional probability distribution for a state at any future instant, given the present state, is unaffected by any additional knowledge of the past history of the system.
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Decisions for determining and guiding present and future objectives from among alternatives.
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