Acute Traumatic Coagulopathy: From Endogenous Acute Coagulopathy to Systemic Acquired Coagulopathy and Back

摘要

Trauma remains the leading cause of death and disability in adults and is responsible for more life lost and, more importantly, quality life lost than heart disease, human immunodeficiency virus/acquired immunodeficiency syndrome, and cerebrovascular disease. Death from bleeding is the primary cause for this mortality and it occurs quickly. Indeed, the majority of deaths from bleeding takes place within the first 6 hours and are heavily weighted toward the first 1 hour to 2 hours after injury.The nature of military injuries compounds these problems. Modern weapons cause massive tissue destruction, and massive hemorrhage is unfortunately all too common. Even with vastly improved triage, evacuation, and early surgical intervention, problems associated with bleeding and the inability to control it remain vexing for both military and civilian trauma surgeons.