title: Prohemostatic interventions in trauma: resuscitation-associated coagulopathy, acute traumatic coagulopathy, hemostatic resuscitation, and other hemostatic interventions.
abstract: Trauma is the most common cause of death in the young and hemorrhage is the most important cause of death in patients with trauma. Recently redefined pathways of inflammation and coagulation, together with hypothermia and acidosis contribute to trauma-associated coagulopathy and aggravation of bleeding. Pharmacological prohemostatic agents may be useful to (partly) correct the coagulopathy in trauma patients and may serve as useful adjunctive treatment options in patients with severe blood loss after trauma. Recombinant factor VIIa, fibrinogen and prothrombin complex concentrates, and antifibrinolytic agents have been evaluated in clinical trials. These interventions show promising effects but their efficacy in reducing clinically important outcome parameters need to be confirmed in clinical studies.
authors.affiliation: Department of Surgery, University of California, San Francisco, California 94110, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Howard
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Daley
authors.forename: Mitchell Jay
authors.initials: MJ
authors.lastname: Cohen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000188:drug therapy* / Q000209:etiology*; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D014947:Wounds and Injuries / Q000097:blood*; D055815:Young Adult
chemical_list: D006490:Hemostatics