The Progress Of Traumatic Coagulopathy Mechanisms And Diagnostic Methods

Post-traumatic bleeding is one of the causes of preventable death in theworld, and death caused by traumatic bleeding accounts for30%-56%ofthe pre-hospital trauma deaths.Bleeding caused by traumaticcoagulopathy is one of the main reasons within the first24hours after thetrauma of preventable death. Acute traumatic coagulopathy (Acutetraumatic coagulopath, ATC) is derived low coagulation status early (<1hour) after a trauma can be monitored in the presence ATC approximately10-25%of trauma patients, and ATC has proved to prolonged bleedingtime, limiting the effect of the recovery, and to mortality in patients withan increase of4times. ATC mainly for low systemic coagulation andfibrinolysis status. Although there are different mechanisms causing theATC academic point of view, but it is widely accepted that ATC is serioustissue damage, shock caused by low perfusion due to systemicinflammation and endothelial injury. Current hypotheses about themechanism of action of the ATC there are three: thrombin-thrombomodulin activated protein C pathway, the doctrine ofcatecholamine-induced endothelial injury and disseminated intravascularcoagulation (DIC) doctrine. In view of the above clinical features of the ATC, a fast, accurate and reliable diagnostic test for the diagnosis andtreatment of ATC seem significant. Conventional coagulation assays(activated partial thromboplastin time and prothrombin time) and plateletcount and fibrinogen concentration measurement has been widely used incoagulation monitoring. Viscoelastic test (TEG and rotation thrombosis)is available as a more accurate method of diagnosis and guide treatment.