Towards early individual goal-directed coagulation management in trauma patients

Towards early individual goal-directed coagulation management in trauma patients.

Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM®)-guided administration of fibrinogen concentrate and prothrombin complex concentrate

INTRODUCTION The appropriate strategy for trauma-induced coagulopathy management is under debate. We report the treatment of major trauma using mainly coagulation factor concentrates. METHODS This retrospective analysis included trauma patients who received >or= 5 units of red blood cell concentrate within 24 hours. Coagulation management was guided by thromboelastometry (ROTEM). Fibrinogen c...

Early and individualized goal-directed therapy for trauma-induced coagulopathy

Severe trauma-related bleeding is associated with high mortality. Standard coagulation tests provide limited information on the underlying coagulation disorder. Whole-blood viscoelastic tests such as rotational thromboelastometry or thrombelastography offer a more comprehensive insight into the coagulation process in trauma. The results are available within minutes and they provide information ...

[Coagulation management in major trauma].

In trauma associated coagulopathy, the initial treatment consists of hypothermia and acidosis have to be treated aggressively. Already in in the emergency room, fibrinogen deficiency can be detected frequently, in addition, colloids interfere with fibrin polymerisation. Under these aspects, the early administration of fibrinogen seems to be justified. Depleted coagulation factors can be substit...

Coagulation management in major trauma

Bleeding is a common problem in major trauma. Coagulopathy could be detected in approximately 25% of all trauma patients on arrival in the emergency room. The reasons for that are blood loss, dilution of the remaining coagulation factors by fluids not containing coagulation factors, consumption of coagulation factors and hyperfibrinolysis. Hypothermia and acidosis are also well described contri...