Clotting Factor Deficiency in Early Trauma-Associated Coagulopathy
Clotting Factor Deficiency in Early Trauma-Associated Coagulopathy
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DOI：
10.1097/ta.0b013e318232e5ab
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发表时间：
2011-11-01
影响因子：
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通讯作者：
Tien, Homer C.
中科院分区：
文献类型：
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作者：
Rizoli, Sandro B.;Scarpelini, Sandro;Tien, Homer C.
背景：凝血病性出血是受伤后院内死亡的主要原因。最近提出的输血策略要求对出血的创伤患者进行早期和积极的冷冻血浆输注，从而通过使用凝血因子（CF）进行抗凝治疗来解决创伤相关凝血病（TAC）。这种策略可能会显着提高出血创伤患者的生存率。然而，其他研究表明，早期TAC发生蛋白C激活，是独立的CF缺乏。本研究调查是否CF缺乏症与早期TAC.Methods：这是一项前瞻性观察性队列研究严重创伤患者（损伤严重程度评分>= 16）入院后不久，受伤，接受最低限度的液体，没有院前血液。测定血液中的CF水平、血栓弹力图和常规凝血试验。严重CF缺乏定义为：
Background: Coagulopathic bleeding is a leading cause of in-hospital death after injury. A recently proposed transfusion strategy calls for early and aggressive frozen plasma transfusion to bleeding trauma patients, thus addressing trauma-associated coagulopathy (TAC) by transfusing clotting factors (CFs). This strategy may dramatically improve survival of bleeding trauma patients. However, other studies suggest that early TAC occurs by protein C activation and is independent of CF deficiency. This study investigated whether CF deficiency is associated with early TAC.Methods: This is a prospective observational cohort study of severely traumatized patients (Injury Severity Score >= 16) admitted shortly after injury, receiving minimal fluids and no prehospital blood. Blood was assayed for CF levels, thromboelastography, and routine coagulation tests. Critical CF deficiency was defined as