Coagulopatía Aguda Traumática y hemorragia masiva: una relación que debemos conocer

[摘要] Accidents and different kind of injuries account for a relevant proportion of death causes from childhood to the fourth decade of life. Death from injury has increased by 20% over the last decade. Hemorrhages are estimated to cause between 30 to 70% of those deaths. Massive bleeding is also known for being one of the main causes of death during surgery in cases with extensive tissue damage from not traumatic origin. In around one third or more of such patients an acute traumatic coagulopathy or trauma associated coagulopathy is developed. This phenomenon obeys to complex, overlapping mechanisms which would be in its major part dependent on the event that caused the blood lost. This kind of coagulopathy can be defined as a functional reduction in clot strength with only minimal changes in clotting times. Its presence increases the risk of a massive bleeding, the use of larger volumes of blood components and the likelihood of dying by the hemorrhage. The early identification of acute traumatic coagulopathy through hemostatic tests such as TP/INR and viscoelastic assays as thrombelastography or rotational thrombelastometry modifies those risks since it brings a feasible therapeutic target to aim at, becoming the cornerstone for the newer transfusional strategies while facing massive bleedings.

[学科分类] 生理学与病理学

[关键词] acute traumatic coagulopathy;massive hemorrhage;massive transfusion;hemostasis assays.