Primary Fibrinolysis Is Integral in the Pathogenesis of the Acute Coagulopathy of Trauma
Primary Fibrinolysis Is Integral in the Pathogenesis of the Acute Coagulopathy of Trauma
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DOI：
10.1097/sla.0b013e3181f09191
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发表时间：
2010-09-01
影响因子：
9
通讯作者：
Sauaia, Angela
中科院分区：
文献类型：
--
作者：
Kashuk, Jeffry L.;Moore, Ernest E.;Sauaia, Angela
背景：原发性纤维蛋白溶解（PF）的存在及其与“创伤急性凝血病”的明确机制联系是有争议的。快速血栓造影（r-TEG）提供凝血系统的护理点综合评估。我们假设损伤后PF发生在严重休克早期，导致损伤后凝血功能障碍，最终导致出血性死亡。方法：连续14个月以上有损伤后凝血功能障碍风险的患者按输血需求分层，分为大量（MT） 10单位/6小时（n = 32）、中度（Mod） 5至9单位/6小时（n = 15）和最小（Min） 15%估计溶血率。凝血功能障碍定义为r-TEG凝块强度= G
Background: The existence of primary fibrinolysis (PF) and a defined mechanistic link to the "Acute Coagulopathy of Trauma" is controversial. Rapid thrombelastography (r-TEG) offers point of care comprehensive assessment of the coagulation system. We hypothesized that postinjury PF occurs early in severe shock, leading to postinjury coagulopathy, and ultimately hemorrhage-related death.Methods: Consecutive patients over 14 months at risk for postinjury coagulopathy were stratified by transfusion requirements into massive (MT) > 10 units/6 hours (n = 32), moderate (Mod) 5 to 9 units/6 hours (n = 15), and minimal (Min) 15% estimated percent lysis was detected. Coagulopathy was defined as r-TEG clot strength = G