Cohen Mitchell J, Christie S Ariane
Department of Surgery, San Francisco General Hospital, University of California, San Francisco, School of Medicine, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
Department of Surgery, San Francisco General Hospital, University of California, San Francisco, School of Medicine, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
Crit Care Clin. 2017 Jan;33(1):101-118. doi: 10.1016/j.ccc.2016.08.003.
Coagulopathy is common after injury and develops independently from iatrogenic, hypothermic, and dilutional causes. Despite considerable research on the topic over the past decade, trauma-induced coagulopathy (TIC) continues to portend poor outcomes, including decreased survival. We review the current evidence regarding the diagnosis and mechanisms underlying trauma induced coagulopathy and summarize the debates regarding optimal management strategy including product resuscitation, potential pharmacologic adjuncts, and targeted approaches to hemostasis. Throughout, we will identify areas of continued investigation and controversy in the understanding and management of TIC.
凝血功能障碍在受伤后很常见,且独立于医源性、低温性和稀释性病因之外发生。尽管在过去十年里对该主题进行了大量研究,但创伤性凝血病(TIC)仍然预示着不良后果,包括生存率降低。我们回顾了有关创伤性凝血病诊断和潜在机制的当前证据,并总结了关于最佳管理策略的争论,包括产品复苏、潜在的药物辅助治疗以及针对性的止血方法。在整个过程中,我们将确定在TIC的理解和管理方面持续研究和存在争议的领域。