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Potential value of pharmacological protocols in trauma
Herbert Schöchl1, Christoph J Schlimp, Wolfgang Voelckel
1Department of Anaesthesiology and Intensive Care, AUVA Trauma Hospital, Salzburg, Austria. herbert.schoechl@auva.at
Current Opinion in Anaesthesiology
|January 17, 2013
Summary
Viscoelastic tests (VETs) aid in diagnosing trauma-induced coagulopathy (TIC). This enables targeted treatment with coagulation factor concentrates for improved patient outcomes in severe trauma.
Area of Science:
- Trauma Care
- Hematology
- Coagulation Disorders
Background:
- Trauma-induced coagulopathy (TIC) poses a significant challenge in trauma care.
- Early and aggressive treatment is crucial for survival in severely bleeding patients.
- Traditional treatments with blood products can be delayed due to thawing requirements.
Purpose of the Study:
- To summarize individualized, goal-directed coagulation management for TIC.
- To highlight the role of viscoelastic tests (VETs) in diagnosing and guiding therapy.
- To discuss the use of coagulation factor concentrates in managing TIC.
Main Methods:
- Review of current literature on trauma-induced coagulopathy.
- Analysis of the application of viscoelastic tests (VETs) like thromboelastometry and thrombelastography.
- Evaluation of treatment strategies including blood products, lyophilized plasma, and coagulation factor concentrates.
Main Results:
- Viscoelastic tests (VETs) provide rapid, comprehensive coagulation assessment.
- Low maximum clot firmness indicates increased transfusion needs and poorer outcomes.
- Early administration of tranexamic acid improves clot stability and outcomes.
- Lyophilized plasma may overcome thawing delays associated with traditional blood products.
Conclusions:
- VETs are valuable for diagnosing TIC by identifying specific coagulation deficits.
- Targeted administration of coagulation factor concentrates based on VET results is recommended.
- Individualized, goal-directed therapy improves management of trauma-induced coagulopathy.
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