Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure

CHEN Shao-chuan; TONG Hua-sheng

doi:10.16766/j.cnki.issn.1674-4152.002423

Volume 20 Issue 4

Apr. 2022

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CHEN Shao-chuan, TONG Hua-sheng. Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure[J]. Chinese Journal of General Practice, 2022, 20(4): 655-660. doi: 10.16766/j.cnki.issn.1674-4152.002423

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CHEN Shao-chuan, TONG Hua-sheng. Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure[J]. Chinese Journal of General Practice, 2022, 20(4): 655-660. doi: 10.16766/j.cnki.issn.1674-4152.002423

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Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure

doi: 10.16766/j.cnki.issn.1674-4152.002423

CHEN Shao-chuan¹
, TONG Hua-sheng^{1, 2
,
,}

1.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China

Funds:

81671896

18CXZ032

Received Date: 2021-09-09
Available Online: 2022-08-20

Abstract

Abstract

The treatment of severe trauma is a global problem. The deaths due to severe trauma accounts for about 10% of the total deaths every year, and the traumatic hemorrhage that caused by trauma-induced coagulopathy (TIC) accounts for 30%-40% of deaths in trauma patients. TIC is comprehensively induced by multiple factors and systems, and the prevention and treatment of TIC is one of the cores of the management of severe trauma or multiple injuries. The complicated mechanism makes the diagnosis and treatment of TIC not timely. The hemorrhagic coagulation failure believes that sever tissue damage and blood loss lead to shock hypoperfusion and oxygen debt, and a series of pathological reactions of the vascular endothelium initiates the occurrence of TIC. This paper attempts to establish a combination of indicators to predict the occurrence of TIC on the basis of this theory. By selecting relevant domestic and foreign literature, the important clinical indicators that involved in the process of blood coagulation failure and the impact of them on the occurrence and progress of TIC were reviewed. The injury severity score, hemoglobin changes, mean arterial pressure, shock index, lactic acid, pH, alkali excess, vascular endothelial glycocalyx, syndecan-1, thrombomodulin (TM) and von Willebrand factor(VWF) factors all have the potential value of evaluating the occurrence and development of TIC in patients. From the perspective of the mechanism of hemorrhagic coagulation failure understanding the mechanism of TIC followed severe tissue trauma, traumatic shock and tissue hypoperfusion and the vascular endothelial disease subsequently, can be used for the implementation of early diagnosis and even treatment of TIC, and also provide reliable combined indicators.
- Severe trauma,
- Trauma-induced coagulopathy,
- Vascular endothelium,
- Endothelial glycocalyx

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References(50)

References

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Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure

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Prediction of traumatic coagulation disease based on the concept of hemorrhagic coagulation failure

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