title: Early and individualized goal-directed therapy for trauma-induced coagulopathy.
abstract: Severe trauma-related bleeding is associated with high mortality. Standard coagulation tests provide limited information on the underlying coagulation disorder. Whole-blood viscoelastic tests such as rotational thromboelastometry or thrombelastography offer a more comprehensive insight into the coagulation process in trauma. The results are available within minutes and they provide information about the initiation of coagulation, the speed of clot formation, and the quality and stability of the clot. Viscoelastic tests have the potential to guide coagulation therapy according to the actual needs of each patient, reducing the risks of over- or under-transfusion. The concept of early, individualized and goal-directed therapy is explored in this review and the AUVA Trauma Hospital algorithm for managing trauma-induced coagulopathy is presented.
authors.affiliation: Ludwig Boltzmann Institute of Experimental and Clinical Traumatology, Vienna, Austria. Herbert.schoechl@auva.at
authors.forename: Herbert
authors.initials: H
authors.lastname: Schöchl
authors.forename: Marc
authors.initials: M
authors.lastname: Maegele
authors.forename: Cristina
authors.initials: C
authors.lastname: Solomon
authors.forename: Klaus
authors.initials: K
authors.lastname: Görlinger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Voelckel
mesh_terms: D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001809:Blood Viscosity; D005340:Fibrinogen / Q000008:administration & dosage; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D020380:Needs Assessment; D010979:Platelet Function Tests; D013916:Thrombelastography; D014947:Wounds and Injuries / Q000150:complications
chemical_list: D000925:Anticoagulants; D005340:Fibrinogen