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Coagulation01:09

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
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Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
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Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
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Trauma Coagulopathy and Its Outcomes.

Gabriele Savioli1,2, Iride Francesca Ceresa1, Sarah Macedonio1

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Medicina (Kaunas, Lithuania)
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Trauma coagulopathy identified in the emergency room correlates with increased need for blood transfusions, hospitalization, and poorer outcomes. Early detection using vital signs like tachycardia is crucial for managing these severe trauma cases.

Keywords:
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Area of Science:

  • Trauma and Emergency Medicine
  • Hematology and Coagulation Disorders
  • Critical Care

Background:

  • Trauma-induced coagulopathy initiates at the moment of injury.
  • Early identification of coagulopathy in trauma patients is critical for management.

Purpose of the Study:

  • To investigate the correlation between trauma coagulopathy on emergency room (ER) arrival and patient outcomes.
  • To assess the relationship between coagulopathy and hemotransfusion needs, hemodynamic instability, injury severity, and hospitalization requirements.
  • To analyze the association of coagulopathy with acidemia, lactate levels, and base excess (BE).

Main Methods:

  • Prospective, monocentric, observational study.
  • Inclusion of 503 major trauma patients admitted to the ER.
  • Analysis of coagulopathy presence, hemotransfusion rates, hemodynamic parameters (including shock index), injury severity scores (ISS), hospitalization data, and biochemical markers.

Main Results:

  • 204 patients (40.5%) presented with trauma coagulopathy.
  • Coagulopathy group showed significantly higher hemotransfusion rates, hemodynamic instability, hypotension, tachycardia, lower oxygen saturation, higher ISS, and more involved anatomical districts.
  • Patients with coagulopathy had increased hospitalization rates, longer hospital and ICU stays, higher mortality, and more frequent acidemia and elevated lactate levels.

Conclusions:

  • Trauma coagulopathy upon ER arrival is linked to greater hemotransfusion needs and higher hospitalization rates.
  • Coagulopathy is associated with increased injury severity, head and abdominal trauma, and male gender.
  • Tachycardia and altered shock index (SI) upon ER arrival can facilitate early detection of trauma coagulopathy.