Top

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Published in:

Open Access 01-12-2012 | Review

Early and individualized goal-directed therapy for trauma-induced coagulopathy

Authors: Herbert Schöchl, Marc Maegele, Cristina Solomon, Klaus Görlinger, Wolfgang Voelckel

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2012

Abstract

Severe trauma-related bleeding is associated with high mortality. Standard coagulation tests provide limited information on the underlying coagulation disorder. Whole-blood viscoelastic tests such as rotational thromboelastometry or thrombelastography offer a more comprehensive insight into the coagulation process in trauma. The results are available within minutes and they provide information about the initiation of coagulation, the speed of clot formation, and the quality and stability of the clot. Viscoelastic tests have the potential to guide coagulation therapy according to the actual needs of each patient, reducing the risks of over- or under-transfusion. The concept of early, individualized and goal-directed therapy is explored in this review and the AUVA Trauma Hospital algorithm for managing trauma-induced coagulopathy is presented.

Available only for authorised users

Kauvar DS, Wade CE: The epidemiology and modern management of traumatic hemorrhage: US and international perspectives. Crit Care. 2005, 9 (Suppl 5): S1-9.PubMedCentralPubMed

Sauaia A, Moore FA, Moore EE, Moser KS, Brennan R, Read RA, Pons PT: Epidemiology of trauma deaths: a reassessment. J Trauma. 1995, 38 (2): 185-193.PubMed

Tien HC, Spencer F, Tremblay LN, Rizoli SB, Brenneman FD: Preventable deaths from hemorrhage at a level I Canadian trauma center. J Trauma. 2007, 62 (1): 142-146.PubMed

Brohi K, Singh J, Heron M, Coats T: Acute traumatic coagulopathy. J Trauma. 2003, 54 (6): 1127-1130.PubMed

Maegele M, Lefering R, Yucel N, Tjardes T, Rixen D, Paffrath T, Simanski C, Neugebauer E, Bouillon B: Early coagulopathy in multiple injury: an analysis from the German Trauma Registry on 8724 patients. Injury. 2007, 38 (3): 298-304.PubMed

Johansson PI: Goal-directed hemostatic resuscitation for massively bleeding patients: the Copenhagen concept. Transfus Apher Sci. 2010, 43 (3): 401-405.PubMed

Kashuk JL, Moore EE, Johnson JL, Haenel J, Wilson M, Moore JB, Cothren CC, Biffl WL, Banerjee A, Sauaia A: Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer?. J Trauma. 2008, 65 (2): 261-270.PubMed

Schochl H, Nienaber U, Hofer G, Voelckel W, Jambor C, Scharbert G, Kozek-Langenecker S, Solomon C: Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM)-guided administration of fibrinogen concentrate and prothrombin complex concentrate. Crit Care. 2010, 14 (2): R55-PubMedCentralPubMed

Chambers LA, Chow SJ, Shaffer LE: Frequency and characteristics of coagulopathy in trauma patients treated with a low- or high-plasma-content massive transfusion protocol. Am J Clin Pathol. 2011, 136 (3): 364-370.PubMed

10.

Hoffman M, Monroe DM: A cell-based model of hemostasis. Thromb Haemost. 2001, 85 (6): 958-965.PubMed

11.

Falati S, Gross P, Merrill-Skoloff G, Furie BC, Furie B: Real-time in vivo imaging of platelets, tissue factor and fibrin during arterial thrombus formation in the mouse. Nat Med. 2002, 8 (10): 1175-1181.PubMed

12.

Mann KG, Brummel K, Butenas S: What is all that thrombin for?. J Thromb Haemost. 2003, 1 (7): 1504-1514.PubMed

13.

Kashuk JL, Moore EE, Sawyer M, Wohlauer M, Pezold M, Barnett C, Biffl WL, Burlew CC, Johnson JL, Sauaia A: Primary fibrinolysis is integral in the pathogenesis of the acute coagulopathy of trauma. Ann Surg. 2010, 252 (3): 434-442.PubMed

14.

Schochl H, Frietsch T, Pavelka M, Jambor C: Hyperfibrinolysis after major trauma: differential diagnosis of lysis patterns and prognostic value of thrombelastometry. J Trauma. 2009, 67 (1): 125-131.PubMed

15.

Theusinger OM, Wanner GA, Emmert MY, Billeter A, Eismon J, Seifert B, Simmen HP, Spahn DR, Baulig W: Hyperfibrinolysis diagnosed by rotational thromboelastometry (ROTEM) is associated with higher mortality in patients with severe trauma. Anesth Analg. 2011, 113 (5): 1003-1012.PubMed

16.

Ganter MT, Hofer CK: Coagulation monitoring: current techniques and clinical use of viscoelastic point-of-care coagulation devices. Anesth Analg. 2008, 106 (5): 1366-1375.PubMed

17.

Dunbar NM, Chandler WL: Thrombin generation in trauma patients. Transfusion. 2009, 49 (12): 2652-2660.PubMed

18.

Hiippala ST, Myllyla GJ, Vahtera EM: Hemostatic factors and replacement of major blood loss with plasma-poor red cell concentrates. Anesth Analg. 1995, 81 (2): 360-365.PubMed

19.

Fries D, Martini WZ: Role of fibrinogen in trauma-induced coagulopathy. Br J Anaesth. 2010, 105 (2): 116-121.PubMed

20.

Adam S, Karger R, Kretschmer V: Photo-optical methods can lead to clinically relevant overestimation of fibrinogen concentration in plasma diluted with hydroxyethyl starch. Clin Appl Thromb Hemost. 2010, 16 (4): 461-471.PubMed

21.

Fenger-Eriksen C, Moore GW, Rangarajan S, Ingerslev J, Sorensen B: Fibrinogen estimates are influenced by methods of measurement and hemodilution with colloid plasma expanders. Transfusion. 2010, 50 (12): 2571-2576.PubMed

22.

Fenger-Eriksen C, Tonnesen E, Ingerslev J, Sorensen B: Mechanisms of hydroxyethyl starch-induced dilutional coagulopathy. J Thromb Haemost. 2009, 7 (7): 1099-1105.PubMed

23.

Davenport R, Manson J, De'ath H, Platton S, Coates A, Allard S, Hart D, Pearse R, Pasi KJ, Maccallum P, Stanworth S, Brohi K: Functional definition and characterization of acute traumatic coagulopathy. Crit Care Med. 2011, 39 (12): 2652-2658.PubMedCentralPubMed

24.

Toulon P, Ozier Y, Ankri A, Fleron MH, Leroux G, Samama CM: Point-of-care versus central laboratory coagulation testing during haemorrhagic surgery. A multicenter study. Thromb Haemost. 2009, 101 (2): 394-401.PubMed

25.

Wilson RF, Dulchavsky SA, Soullier G, Beckman B: Problems with 20 or more blood transfusions in 24 hours. Am Surg. 1987, 53 (7): 410-417.PubMed

26.

Cotton BA, Faz G, Hatch QM, Radwan ZA, Podbielski J, Wade C, Kozar RA, Holcomb JB: Rapid thrombelastography delivers real-time results that predict transfusion within 1 hour of admission. J Trauma. 2011, 71 (2): 407-414.PubMed

27.

Johansson PI, Stissing T, Bochsen L, Ostrowski SR: Thrombelastography and thromboelastometry in assessing coagulopathy in trauma. Scand J Trauma Resusc Emerg Med. 2009, 17: 45-PubMedCentralPubMed

28.

Kashuk JL, Moore EE, Sawyer M, Le T, Johnson J, Biffl WL, Cothren CC, Barnett C, Stahel P, Sillman CC, Sauaia A, Banerjee A: Postinjury coagulopathy management: goal directed resuscitation via POC thrombelastography. Ann Surg. 2010, 251 (4): 604-614.PubMed

29.

Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondejar E, Hunt BJ, Komadina R, Nardi G, Neugebauer E, Ozier Y, Riddez L, Schultz A, Stahel PF, Vincent JL, Spahn DR: Management of bleeding following major trauma: an updated European guideline. Crit Care. 2010, 14 (2): R52-PubMedCentralPubMed

30.

Schochl H, Cotton B, Inaba K, Nienaber U, Fischer H, Voelckel W, Solomon C: FIBTEM provides early prediction of massive transfusion in trauma. Crit Care. 2011, 15 (6): R265-PubMedCentralPubMed

31.

Luddington RJ: Thrombelastography/thromboelastometry. Clin Lab Haematol. 2005, 27 (2): 81-90.PubMed

32.

Solomon C, Traintinger S, Ziegler B, Hanke A, Rahe-Meyer N, Voelckel W, Schochl H: Platelet function following trauma. A Multiple Electrode Aggregometry study. Thromb Haemost. 2011, 106 (2): 322-330.PubMed

33.

Swallow RA, Agarwala RA, Dawkins KD, Curzen NP: Thromboelastography: potential bedside tool to assess the effects of antiplatelet therapy?. Platelets. 2006, 17 (6): 385-392.PubMed

34.

Toth O, Calatzis A, Penz S, Losonczy H, Siess W: Multiple electrode aggregometry: a new device to measure platelet aggregation in whole blood. Thromb Haemost. 2006, 96 (6): 781-788.PubMed

35.

Geeraedts LM, Demiral H, Schaap NP, Kamphuisen PW, Pompe JC, Frolke JP: 'Blind' transfusion of blood products in exsanguinating trauma patients. Resuscitation. 2007, 73 (3): 382-388.PubMed

36.

Gonzalez EA, Moore FA, Holcomb JB, Miller CC, Kozar RA, Todd SR, Cocanour CS, Balldin BC, McKinley BA: Fresh frozen plasma should be given earlier to patients requiring massive transfusion. J Trauma. 2007, 62 (1): 112-119.PubMed

37.

Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, Sebesta J, Jenkins D, Wade CE, Holcomb JB: The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma. 2007, 63 (4): 805-813.PubMed

38.

Cotton BA, Au BK, Nunez TC, Gunter OL, Robertson AM, Young PP: Predefined massive transfusion protocols are associated with a reduction in organ failure and postinjury complications. J Trauma. 2009, 66 (1): 41-48.PubMed

39.

Duchesne JC, Kimonis K, Marr AB, Rennie KV, Wahl G, Wells JE, Islam TM, Meade P, Stuke L, Barbeau JM, Hunt JP, Baker CC, McSwain NE: Damage control resuscitation in combination with damage control laparotomy: a survival advantage. J Trauma. 2010, 69 (1): 46-52.PubMed

40.

Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, Gonzalez EA, Pomper GJ, Perkins JG, Spinella PC, Williams KL, Park MS: Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008, 248 (3): 447-458.PubMed

41.

Lustenberger T, Frischknecht A, Bruesch M, Keel MJ: Blood component ratios in massively transfused, blunt trauma patients--a time-dependent covariate analysis. J Trauma. 2011, 71 (5): 1144-1150.PubMed

42.

Maegele M, Lefering R, Paffrath T, Tjardes T, Simanski C, Bouillon B: Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie. Vox Sang. 2008, 95 (2): 112-119.PubMed

43.

Cotton BA, Gunter OL, Isbell J, Au BK, Robertson AM, Morris JA, St Jacques P, Young PP: Damage control hematology: the impact of a trauma exsanguination protocol on survival and blood product utilization. J Trauma. 2008, 64 (5): 1177-1182.PubMed

44.

Johansson PI, Stensballe J: Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after study. Vox Sang. 2009, 96 (2): 111-118.PubMedCentralPubMed

45.

Schuster KM, Davis KA, Lui FY, Maerz LL, Kaplan LJ: The status of massive transfusion protocols in United States trauma centers: massive transfusion or massive confusion?. Transfusion. 2010, 50 (7): 1545-1551.PubMed

46.

Cotton BA, Dossett LA, Haut ER, Shafi S, Nunez TC, Au BK, Zaydfudim V, Johnston M, Arbogast P, Young PP: Multicenter validation of a simplified score to predict massive transfusion in trauma. J Trauma. 2010, 69 (Suppl 1): S33-39.PubMed

47.

McLaughlin DF, Niles SE, Salinas J, Perkins JG, Cox ED, Wade CE, Holcomb JB: A predictive model for massive transfusion in combat casualty patients. J Trauma. 2008, 64 (2 Suppl): S57-63.PubMed

48.

Rainer TH, Ho AM, Yeung JH, Cheung NK, Wong RS, Tang N, Ng SK, Wong GK, Lai PB, Graham CA: Early risk stratification of patients with major trauma requiring massive blood transfusion. Resuscitation. 2011, 82 (6): 724-729.PubMed

49.

Yucel N, Lefering R, Maegele M, Vorweg M, Tjardes T, Ruchholtz S, Neugebauer EA, Wappler F, Bouillon B, Rixen D: Trauma Associated Severe Hemorrhage (TASH)-Score: probability of mass transfusion as surrogate for life threatening hemorrhage after multiple trauma. J Trauma. 2006, 60 (6): 1228-1236.PubMed

50.

Hirshberg A, Dugas M, Banez EI, Scott BG, Wall MJ, Mattox KL: Minimizing dilutional coagulopathy in exsanguinating hemorrhage: a computer simulation. J Trauma. 2003, 54 (3): 454-463.PubMed

51.

Murad MH, Stubbs JR, Gandhi MJ, Wang AT, Paul A, Erwin PJ, Montori VM, Roback JD: The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis. Transfusion. 2010, 50 (6): 1370-1383.PubMed

52.

Davenport R, Curry N, Manson J, De'Ath H, Coates A, Rourke C, Pearse R, Stanworth S, Brohi K: Hemostatic effects of fresh frozen plasma may be maximal at red cell ratios of 1:2. J Trauma. 2011, 70 (1): 90-95.PubMed

53.

Rahbar MH, Fox EE, Del Junco DJ, Cotton BA, Podbielski JM, Matijevic N, Cohen MJ, Schreiber MA, Zhang J, Mirhaji P, Duran SJ, Reynolds RJ, Benjamin-Garner R, Holcomb JB: Coordination and management of multicenter clinical studies in trauma: Experience from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study. Resuscitation. 2011,

54.

Simmons JW, White CE, Eastridge BJ, Mace JE, Wade CE, Blackbourne LH: Impact of policy change on US Army combat transfusion practices. J Trauma. 2010, 69 (Suppl 1): S75-80.PubMed

55.

Dirks J, Jorgensen H, Jensen CH, Ostrowski SR, Johansson PI: Blood product ratio in acute traumatic coagulopathy--effect on mortality in a Scandinavian level 1 trauma centre. Scand J Trauma Resusc Emerg Med. 2010, 18: 65-PubMedCentralPubMed

56.

Riskin DJ, Tsai TC, Riskin L, Hernandez-Boussard T, Purtill M, Maggio PM, Spain DA, Brundage SI: Massive transfusion protocols: the role of aggressive resuscitation versus product ratio in mortality reduction. J Am Coll Surg. 2009, 209 (2): 198-205.PubMed

57.

de Biasi AR, Stansbury LG, Dutton RP, Stein DM, Scalea TM, Hess JR: Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma (CME). Transfusion. 2011, 51 (9): 1925-1932.PubMedCentralPubMed

58.

Chaiwat O, Lang JD, Vavilala MS, Wang J, MacKenzie EJ, Jurkovich GJ, Rivara FP: Early packed red blood cell transfusion and acute respiratory distress syndrome after trauma. Anesthesiology. 2009, 110 (2): 351-360.PubMed

59.

Inaba K, Branco BC, Rhee P, Blackbourne LH, Holcomb JB, Teixeira PG, Shulman I, Nelson J, Demetriades D: Impact of plasma transfusion in trauma patients who do not require massive transfusion. J Am Coll Surg. 2010, 210 (6): 957-965.PubMed

60.

Johnson JL, Moore EE, Kashuk JL, Banerjee A, Cothren CC, Biffl WL, Sauaia A: Effect of blood products transfusion on the development of postinjury multiple organ failure. Arch Surg. 2010, 145 (10): 973-977.PubMed

61.

Sambasivan CN, Kunio NR, Nair PV, Zink KA, Michalek JE, Holcomb JB, Schreiber MA, Wade CE, Brasel KJ, Vercruysse G, MacLeod J, Dutton RP, Hess JR, Duchesne JC, McSwain NE, Muskat P, Johannigamn J, Cryer HM, Tillou A, Cohen MJ, Pittet JF, Knudson P, De Moya MA, Tieu B, Brundage S, Napolitano LM, Brunsvold M, Sihler KC, Beilman G, Peitzman AB: High ratios of plasma and platelets to packed red blood cells do not affect mortality in nonmassively transfused patients. J Trauma. 2011, 71 (2 Suppl 3): S329-336.PubMed

62.

Watson GA, Sperry JL, Rosengart MR, Minei JP, Harbrecht BG, Moore EE, Cuschieri J, Maier RV, Billiar TR, Peitzman AB: Fresh frozen plasma is independently associated with a higher risk of multiple organ failure and acute respiratory distress syndrome. J Trauma. 2009, 67 (2): 221-227.PubMed

63.

Leemann H, Lustenberger T, Talving P, Kobayashi L, Bukur M, Brenni M, Bruesch M, Spahn DR, Keel MJ: The role of rotation thromboelastometry in early prediction of massive transfusion. J Trauma. 2010, 69 (6): 1403-1408.PubMed

64.

Nystrup KB, Windelov NA, Thomsen AB, Johansson PI: Reduced clot strength upon admission, evaluated by thrombelastography (TEG), in trauma patients is independently associated with increased 30-day mortality. Scand J Trauma Resusc Emerg Med. 2011, 19: 52-PubMedCentralPubMed

65.

Pezold M, Moore EE, Wohlauer M, Sauaia A, Gonzalez E, Banerjee A, Silliman CC: Viscoelastic clot strength predicts coagulation-related mortality within 15 minutes. Surgery. 2011,

66.

Plotkin AJ, Wade CE, Jenkins DH, Smith KA, Noe JC, Park MS, Perkins JG, Holcomb JB: A reduction in clot formation rate and strength assessed by thrombelastography is indicative of transfusion requirements in patients with penetrating injuries. J Trauma. 2008, 64 (2 Suppl): S64-68.PubMed

67.

Schochl H, Solomon C, Traintinger S, Nienaber U, Tacacs-Tolnai A, Windhofer C, Bahrami S, Voelckel W: Thromboelastometric (ROTEM) Findings in Patients Suffering from Isolated Severe Traumatic Brain Injury. J Neurotrauma. 2011, 28 (10): 2033-2041.PubMed

68.

Stinger HK, Spinella PC, Perkins JG, Grathwohl KW, Salinas J, Martini WZ, Hess JR, Dubick MA, Simon CD, Beekley AC, Wolf SE, Wade CE, Holcomb JB: The ratio of fibrinogen to red cells transfused affects survival in casualties receiving massive transfusions at an army combat support hospital. J Trauma. 2008, 64 (2 Suppl): S79-85.PubMed

69.

Theusinger OM, Baulig W, Seifert B, Emmert MY, Spahn DR, Asmis LM: Relative concentrations of haemostatic factors and cytokines in solvent/detergent-treated and fresh-frozen plasma. Br J Anaesth. 2011, 106 (4): 505-511.PubMed

70.

Chowdhury P, Saayman AG, Paulus U, Findlay GP, Collins PW: Efficacy of standard dose and 30 ml/kg fresh frozen plasma in correcting laboratory parameters of haemostasis in critically ill patients. Br J Haematol. 2004, 125 (1): 69-73.PubMed

71.

Shuja F, Shults C, Duggan M, Tabbara M, Butt MU, Fischer TH, Schreiber MA, Tieu B, Holcomb JB, Sondeen JL, Demoya M, Velmahos GC, Alam HB: Development and testing of freeze-dried plasma for the treatment of trauma-associated coagulopathy. J Trauma. 2008, 65 (5): 975-985.PubMed

72.

Sorensen B, Bevan D: A critical evaluation of cryoprecipitate for replacement of fibrinogen. Br J Haematol. 2010, 149 (6): 834-843.PubMed

73.

Callum JL, Karkouti K, Lin Y: Cryoprecipitate: the current state of knowledge. Transfus Med Rev. 2009, 23 (3): 177-188.PubMed

74.

Nascimento B, Rizoli S, Rubenfeld G, Fukushima R, Ahmed N, Nathens A, Lin Y, Callum J: Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma. Transfus Med. 2011, 21 (6): 394-401.PubMed

75.

Rahe-Meyer N, Sorensen B: For: Fibrinogen concentrate for management of bleeding. J Thromb Haemost. 2011, 9 (1): 1-5.PubMed

76.

Solomon C, Pichlmaier U, Schoechl H, Hagl C, Raymondos K, Scheinichen D, Koppert W, Rahe-Meyer N: Recovery of fibrinogen after administration of fibrinogen concentrate to patients with severe bleeding after cardiopulmonary bypass surgery. Br J Anaesth. 2010, 104 (5): 555-562.PubMedCentralPubMed

77.

Dickneite G, Pragst I, Joch C, Bergman GE: Animal model and clinical evidence indicating low thrombogenic potential of fibrinogen concentrate (Haemocomplettan P). Blood Coagul Fibrinolysis. 2009, 20 (7): 535-540.PubMed

78.

Kozek-Langenecker S, Sorensen B, Hess JR, Spahn DR: Clinical effectiveness of fresh frozen plasma compared with fibrinogen concentrate: a systematic review. Crit Care. 2011, 15 (5): R239-PubMedCentralPubMed

79.

Sorensen B, Spahn DR, Innerhofer P, Spannagl M, Rossaint R: Clinical review: Prothrombin complex concentrates--evaluation of safety and thrombogenicity. Crit Care. 2011, 15 (1): 201-PubMedCentralPubMed

80.

Hess JR, Lindell AL, Stansbury LG, Dutton RP, Scalea TM: The prevalence of abnormal results of conventional coagulation tests on admission to a trauma center. Transfusion. 2009, 49 (1): 34-39.PubMed

81.

Allen SR, Kashuk JL: Unanswered questions in the use of blood component therapy in trauma. Scand J Trauma Resusc Emerg Med. 2011, 19: 5-PubMedCentralPubMed

82.

Tauber H, Innerhofer P, Breitkopf R, Westermann I, Beer R, El Attal R, Strasak A, Mittermayr M: Prevalence and impact of abnormal ROTEM(R) assays in severe blunt trauma: results of the 'Diagnosis and Treatment of Trauma-Induced Coagulopathy (DIA-TRE-TIC) study'. Br J Anaesth. 2011, 107 (3): 378-387.PubMed

83.

Brohi K, Cohen MJ, Ganter MT, Schultz MJ, Levi M, Mackersie RC, Pittet JF: Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma. 2008, 64 (5): 1211-1217.PubMed

84.

Weiss G, Lison S, Spannagl M, Heindl B: Expressiveness of global coagulation parameters in dilutional coagulopathy. Br J Anaesth. 2010, 105 (4): 429-436.PubMed

85.

Boffard KD, Riou B, Warren B, Choong PI, Rizoli S, Rossaint R, Axelsen M, Kluger Y: Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials. J Trauma. 2005, 59 (1): 8-15.PubMed

86.

Schochl H, Nienaber U, Maegele M, Hochleitner G, Primavesi F, Steitz B, Arndt C, Hanke A, Voelckel W, Solomon C: Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care. 2011, 15 (2): R83-PubMedCentralPubMed

87.

Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejia-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S: Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010, 376 (9734): 23-32.PubMed

88.

Hauser CJ, Boffard K, Dutton R, Bernard GR, Croce MA, Holcomb JB, Leppaniemi A, Parr M, Vincent JL, Tortella BJ, Dimsits J, Bouillon B: Results of the CONTROL trial: efficacy and safety of recombinant activated Factor VII in the management of refractory traumatic hemorrhage. J Trauma. 2010, 69 (3): 489-500.PubMed

89.

Grottke O, Braunschweig T, Spronk HM, Esch S, Rieg AD, van Oerle R, ten Cate H, Fitzner C, Tolba R, Rossaint R: Increasing concentrations of prothrombin complex concentrate induce disseminated intravascular coagulation in a pig model of coagulopathy with blunt liver injury. Blood. 2011, 118 (7): 1943-1951.PubMed

90.

Warren O, Simon B: Massive, fatal, intracardiac thrombosis associated with prothrombin complex concentrate. Ann Emerg Med. 2009, 53 (6): 758-761.PubMed

91.

Toker S, Hak DJ, Morgan SJ: Deep vein thrombosis prophylaxis in trauma patients. Thrombosis. 2011, 2011: 505373-PubMedCentralPubMed

92.

Kalina U, Bickhard H, Schulte S: Biochemical comparison of seven commercially available prothrombin complex concentrates. Int J Clin Pract. 2008, 62 (10): 1614-1622.PubMed

93.

Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, Dewan Y, Gando S, Guyatt G, Hunt BJ, Morales C, Perel P, Prieto-Merino D, Woolley T: The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011, 377 (9771): 1096-1101.PubMed

94.

Yang L, Stanworth S, Hopewell S, Doree C, Murphy M: Is fresh-frozen plasma clinically effective? An update of a systematic review of randomized controlled trials. Transfusion. 2012,

Title: Early and individualized goal-directed therapy for trauma-induced coagulopathy
Authors: Herbert Schöchl
Marc Maegele
Cristina Solomon
Klaus Görlinger
Wolfgang Voelckel
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2012
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-20-15

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early and individualized goal-directed therapy for trauma-induced coagulopathy

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2012

Structured classification for ED presenting complaints – from free text field-based approach to ICPC-2 ED application

Critical care considerations in the management of the trauma patient following initial resuscitation

Early do-not-resuscitate orders in intracerebral haemorrhage; frequency and predictive value for death and functional outcome. A retrospective cohort study

Physician staffed helicopter emergency medical service dispatch via centralised control or directly by crew – case identification rates and effect on the Sydney paediatric trauma system

The impact of CPR and AED training on healthcare professionals' self-perceived attitudes to performing resuscitation

The trauma patient in hemorrhagic shock: how is the C-priority addressed between emergency and ICU admission?