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European Journal of Trauma and Emergency Surgery

Published in:

01-02-2018 | Review Article

Fibrinolysis in trauma: a review

Authors: M. J. Madurska, K. A. Sachse, J. O. Jansen, T. E. Rasmussen, J. J. Morrison

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2018

Abstract

Fibrinolytic dysregulation is an important mechanism in traumatic coagulopathy. It is an incompletely understood process that consists of a spectrum ranging from excessive breakdown (hyperfibrinolysis) and the shutdown of fibrinolysis. Both hyperfibrinolysis and shutdown are associated with excess mortality and post-traumatic organ failure. The pathophysiology appears to relate to endothelial injury and hypoperfusion, with several molecular markers identified in playing a role. Although there are no universally accepted diagnostic tests, viscoelastic studies appear to offer the greatest potential for timely identification of patients presenting with fibrinolytic dysregulation. Treatment is multimodal, involving prompt hemorrhage control and resuscitation, with controversy surrounding the use of antifibrinolytic drug therapy. This review presents the current evidence on the pathophysiology, diagnostic challenges, as well as the management of this hemostatic dysfunction.

Level of evidence: Level III.

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Title: Fibrinolysis in trauma: a review
Authors: M. J. Madurska
K. A. Sachse
J. O. Jansen
T. E. Rasmussen
J. J. Morrison
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2018
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-017-0833-3

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Fibrinolysis in trauma: a review

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