{"title":"根据粘弹性测试(VET)更新急性创伤出血和创伤诱发凝血病(TIC)的病理生理学和治疗方法。","authors":"Marc Maegele","doi":"10.15441/ceem.24.202","DOIUrl":null,"url":null,"abstract":"<p><p>Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are the two predominant causes of preventable death after trauma. Early control of bleeding sources and rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of hemorrhage and TIC from acute trauma, even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467455/pdf/","citationCount":"0","resultStr":"{\"title\":\"Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing.\",\"authors\":\"Marc Maegele\",\"doi\":\"10.15441/ceem.24.202\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are the two predominant causes of preventable death after trauma. Early control of bleeding sources and rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of hemorrhage and TIC from acute trauma, even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC.</p>\",\"PeriodicalId\":10325,\"journal\":{\"name\":\"Clinical and Experimental Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467455/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Emergency Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15441/ceem.24.202\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15441/ceem.24.202","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing.
Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are the two predominant causes of preventable death after trauma. Early control of bleeding sources and rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of hemorrhage and TIC from acute trauma, even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC.