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Updated: May 15, 2026
04:56
Determination of the Procoagulant Activity of Extracellular Vesicle (EV) Using EV-Activated Clotting Time (EV-ACT)
Published on: August 4, 2023
Pathogenesis of acute traumatic coagulopathy
1Trauma Sciences, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK. ross.davenport@qmul.ac.uk
Transfusion
|January 11, 2013
Summary
Acute traumatic coagulopathy (ATC), a bleeding disorder post-trauma, worsens patient outcomes. Rapid diagnostics like TEG/ROTEM are crucial for managing severe trauma hemorrhage effectively.
Area of Science:
- Trauma and Emergency Medicine
- Hematology
- Critical Care Medicine
Background:
- Acute traumatic coagulopathy (ATC) is an early process in polytrauma patients, driven by tissue injury and shock, leading to increased mortality.
- Protein C activation by endothelial cells is a key mechanism causing rapid anticoagulation and fibrinolysis in ATC.
- Factors like blood loss, hypothermia, acidosis, and hemodilution exacerbate ATC, causing systemic hemostasis derangement.
Purpose of the Study:
- To review the pathophysiology of ATC.
- To discuss the role of rapid diagnostics in managing severe trauma hemorrhage.
- To explore diagnostic and therapeutic strategies considering prehospital times and remote damage control resuscitation.
Main Methods:
- Literature review summarizing current understanding of ATC pathophysiology.
- Analysis of diagnostic and therapeutic strategies for bleeding trauma patients.
- Evaluation of the role of rapid diagnostics (TEG/ROTEM) versus conventional tests.
Main Results:
- Endothelial Protein C activation is central to ATC's rapid anticoagulation and fibrinolysis.
- Conventional coagulation tests have limited early value in major trauma hemorrhage.
- Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) offer rapid clot dynamics evaluation.
Conclusions:
- ATC is a complex process involving multiple hemostatic components, with potential novel therapeutic targets.
- Rapid diagnostics, particularly TEG and ROTEM, are superior to conventional tests for early trauma hemorrhage management.
- Tailoring diagnostic and therapeutic strategies based on prehospital times is essential for effective remote damage control resuscitation.
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