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Updated: Sep 30, 2025

Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
04:56

Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients

Published on: August 4, 2023

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Coronavirus-Associated Coagulopathy After Trauma

Kevin D Kirkland1, William F Powers1, Elizabeth Acquista1

  • 1Department of General Surgery, 24520New Hanover Regional Medical Center, Wilmington, NC, USA.

The American Surgeon
|March 11, 2022
PubMed

Insights

COVID-19-associated coagulopathy (CAC) increases venous thromboembolism risk. This case highlights managing severe pulmonary emboli and cardiogenic shock in a trauma patient with recent COVID-19.

Area of Science:

  • Medicine
  • Critical Care
  • Trauma Surgery

Background:

  • COVID-19 is associated with a hypercoagulable state, known as COVID-19-associated coagulopathy (CAC).
  • Elevated factor VIII, fibrinogen, and blood hyperviscosity contribute to increased venous thromboembolism risk in CAC patients.

Observation:

  • A patient with recent COVID-19 infection and no prior medical history sustained femur fractures after a motorcycle collision.
  • Following retrograde intramedullary nailing for femur fractures, the patient developed immediate massive bilateral pulmonary emboli and subsequent cardiogenic shock.

Findings:

  • Initial treatment with tissue plasminogen activator via pulmonary artery thrombolysis catheters was ineffective.
  • Extracorporeal membrane oxygenation was initiated for cardiogenic shock, leading to patient recovery over a 58-day hospitalization.

Implications:

  • This case underscores the complex interplay between COVID-19-associated coagulopathy, trauma, and surgical critical care.
  • Effective management strategies for severe thromboembolic events in post-COVID-19 trauma patients are crucial.
  • The report discusses the role of surgical critical care in managing CAC-related complications.

Keywords:
coronavirus-associated coagulopathygeneral surgerysurgical critical carethoracic surgerytrauma

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