TRAUMA AND COAGULOPATHY: FINDINGS OF THE LAST DECADE

Dr. Debashish Paul* and Dr. S.N. Kulkarni+

ABSTRACT

Acute traumatic Coagulopathy (ATC) is a factor of concern that must be addressed in the care of severely injured patients. In this review article, we discuss the pathophysiology of ATC, the diagnosis and recommendations for its treatment. In the last decade, lots of studies have been reported regarding management of trauma cases with guidelines advocated by each and every researcher .Concept of damage controlled resuscitation has come up in the back ground of Gulf war and intensive research work by British and US Military setup. Apart from ATC, there is Coagulopathy which is secondary to overt volume therapy, leading to other conditions like acidosis, hypothermia, and dilution. This Coagulopathy may, then, be an integral component of the so- called ‘‘vicious cycle’’ when combined with acidosis and hypothermia, also termed as lethal triad. The awareness of the specific pathophysiology and management of a case of Coagulopathy with a specific guideline is of paramount importance. The guidelines and protocol stand firm till date with some minor changes in priorities in conditions where patients are already a known case of Coagulation disorder. In this article we have tried to correlate the recent outcomes of ATC and practical problems encountered in routine practice.

Keywords: Acute Traumatic Coagulopathy Damage Control Resuscitation Pathophysiology of Coagulopathy.