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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
Summary
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.
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