The Central Role of Fibrinolytic Response in Trauma-Induced Coagulopathy: A Hematologist's Perspective.

Abstract:

:Severe trauma is the leading cause of death globally. Though improved resuscitation, particularly early initiation, has reduced the 24-hour mortality rate, the overall morbidity and 30-day mortality remain high mostly due to massive hemorrhage and head injury in the early stages and sepsis and multiorgan failure later on. With recent clinical trials of antifibrinolytic treatment with tranexamic acid, and with the observations that fibrinolytic activity varies widely among the injured patients, the role of the fibrinolytic system in trauma has become a major focus of investigations in trauma-induced coagulopathy. Most of the body's response to trauma involves the endothelium, tissue factor release, and platelet activation. In addition, there are inflammatory and immune responses. All these events directly or indirectly affect the fibrinolytic system. A full understanding of these mechanisms has translational implications on the management of these patients. In this article, the multifaceted responses of fibrinolysis following injury are reviewed.

journal_name

Semin Thromb Hemost

authors

Kwaan HC

doi

10.1055/s-0039-3402428

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

116-124

issue

2

eissn

0094-6176

issn

1098-9064

journal_volume

46

pub_type

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