Presentation Description / Summary: Acute traumatic coagulopathy (ATC) can be caused by severe trauma and traumatic shock. Some of the important drivers of ATC are activation of protein C, endothelial glycocalyx disruption, consumption of fibrinogen, and depletion and dysfunction of platelets. ATC combined with resuscitation-associated coagulopathy is often referred to as trauma-induced coagulopathy. Understanding the pathophysiology of this process is essential for optimal medical and surgical management of these patients that otherwise have high morbidity and mortality. It is well known that this coagulopathy can be worsened by improper medical management including large volume crystalloid administration and inadequate administration of plasma and platelets when blood products are needed. Damage control resuscitation should be utilized in these patients. Additional prospective randomized studies are needed to determine the most effective protocols. In the limited studies available to date, ATC has been shown to occur rarely in veterinary patients, but more studies with severely injured patients are needed.
Learning Objectives:
describe the pathophysiology of acute traumatic coagulopathy and resuscitation associated coagulopathy
list the diagnostic tests that can be used to confirm the presence of ATC
optimize care for patients at risk for ATC by utilizing appropriate fluid therapy resusciation and other therapies
