title: Acute coagulopathy in pediatric trauma.
abstract: OBJECTIVE
  To summarize our current understanding of the pathophysiology, diagnosis, and management of acute traumatic coagulopathy in children.
  
  
  RESULTS
  Traumatic coagulopathy is a complex process that leads to global dysfunction of the endogenous coagulation system and results in worse outcomes and increased mortality. Although the cause is multifactorial, it is common in severely injured patients and is driven by significant tissue injury and hypoperfusion. Viscoelastic coagulation tests have been established as a rapid and reliable method to assess traumatic coagulopathy. Additionally, massive transfusion protocols have improved outcomes in adults, but limited studies in pediatrics have not shown any difference in mortality.
  
  
  CONCLUSIONS
  Prospective studies are needed to determine how to best diagnose and manage acute traumatic coagulopathy in children.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, St Louis Children's Hospital, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Choi
authors.forename: Adam M
authors.initials: AM
authors.lastname: Vogel
mesh_terms: D000208:Acute Disease; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D001780:Blood Coagulation Tests / Q000379:methods*; D001803:Blood Transfusion / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015601:Injury Severity Score; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012151:Resuscitation; D012307:Risk Factors; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013916:Thrombelastography; D014947:Wounds and Injuries / Q000150:complications* / Q000503:physiopathology / Q000628:therapy