Goal-directed therapy in trauma induced coagulopathy and focus on traumatic brain injury

Reviews in Health Care

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Title Goal-directed therapy in trauma induced coagulopathy and focus on traumatic brain injury
Creator Görlinger, Klaus
Subject Clinical Medicine
Goal-directed therapy; Trauma induced coagulopathy (TIC); Traumatic brain injury (TBI); ROTEM®
Description In recent years there have been major advances in the management of trauma-induced coagulopathy (TIC) and many experiences have demonstrated how we can achieve significant improvements with multidisciplinary approach and implementation of standardized protocols and algorithms. Central nervous system injuries and exanguination remain the primary causes of early trauma-related mortality. Traumatic brain injuries (TBI) make hemostasis in TIC even more complex and it is known that the onset of coagulopathy in a patient with severe brain injury has a negative impact on the patient’s outcome in terms of mortality. Standard coagulation tests provide limited information on coagulation disorder. The advantages of whole-blood viscoelastic tests, such as rotational thromboelastometry or thrombelastography, are shorter turn-around time and better diagnostic performance compared to routine plasmatic coagulation tests. In contrast to a fixed ratio of FFP:PC:RBC, the aim of the goal-directed coagulation therapy is to set treatment to the actual needs of the individual patient, based on viscoelastic test results. This article describes the improvements achieved through the implementation of ROTEM-guided treatment algorithms for visceral surgery and liver trasplantation, severe trauma and post-partum hemorrhage and cardiovascular surgery.
Publisher SEEd
Date 2013-09-15
Type info:eu-repo/semantics/article

Format text/html
Identifier https://journals.edizioniseed.it/index.php/rhc/article/view/877
Source Reviews in Health Care; Vol 4, No 3S (2013); 17-29
Language eng
Relation https://journals.edizioniseed.it/index.php/rhc/article/view/877/990

Rights Copyright (c) 2013 Seed

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