Trauma Induced Coagulopathy

Hunter B. MooreTransplant Surgery FellowDepartment of SurgeryUniversity of ColoradoAurora, COUSAErnest E. MooreDepartment of SurgeryUniversity of Colorado Denver Ernest E Moore Shock Trauma Center at Denver HealthDenver, COUSAMatthew D. NealDepartment of SurgeryUniversity of Pittsburgh Medical CenterPittsburgh, PAUSA

• Historical Perspective of Trauma Induced Coagulopathy.- Epidemiology of Hemorrhage-related Mortality.- Cell-Mediated Hemostasis.- Thrombin-Antithrombin System.- Physiology of Hemostasis: Plasmin-antiplasmin system.- Thrombin Formation.- Platelets.- Fibrinogen.- Defining and Assessing the Endotheliopathy of Trauma and its Implications on Trauma Induced Coagulopathy and Trauma Related Outcomes.- Protein C.- Fibrinolysis Dysregulation following Trauma.- Complement System.- Neutrophils, Inflammation and Innate Immunity in Trauma-Induced Coagulopathy.- Disseminated Intravascular Coagulation.- Grading Clinical Coagulopathy and Predicting Massive Transfusion.- Prothrombin and Partial Thromboplastin Time.- Fibrinogen Assays.- Rotational Thromboelastometry (ROTEM®).- Thromboelastography (TEG® 5000 and TEG® 6s Hemostasis Analyzers with TEG Manager® Software).- Red Blood Cell Transfusions.- Plasma Transfusion.- Cryoprecipitate/ Fibrinogen Concentrate Transfusions.- Platelet Transfusion.- Whole Blood for the Resuscitation of Massively Bleeding Civilian Patients.- Adjunct Factor Replacement .- Anti-fibrinolytics.- Ratio Driven Massive Transfusion Protocols.- Goal-Directed Massive Transfusion Management.- Pre-Hospital Resuscitation.- Venous Thromboembolism after Trauma.- Fibrinolysis Shutdown and Venous Thromboembolism.- Congenital and Acquired Hypercoagulable States.- Pediatrics.- Traumatic Brain Injury-Induced Coagulopathy.- Blunt Solid Organ Injury: A Call for Timely Chemoprophylaxis in the Setting of Early Hypercoagulability.- Pregnancy.- Liver Failure.- Pulmonary Coagulation in the Pathogenesis of Trauma-Associated Acute Respiratory Distress Syndrome.- Management of Chronically Anticoagulated Patients.- Randomized Controlled Trials: Informing Clinical Practice for Traumatically Injured Patients.- The Quantra® System and SEER Sonorheometry.- Dried Plasma for Trauma Resuscitation.- Synthetic Blood Substitutes.- Flow-Based Coagulation and Fibrinolysis Assays.- Animal Models ofCoagulopathy.- Applications of Viscoelastic Hemostatic Assays at the Site of Care: Considerations and Implications.