Background: Traumatic injury results in both physical and physiologic insult. Successful care of the trauma patient depends upon timely correction of both physical and biochemical injury. Trauma-induced coagulopathy is a derangement of hemostasis and thrombosis that develops rapidly and can be fatal if not corrected. Viscoelastic monitoring (VEM) assays have been developed to provide rapid, accurate, and relatively comprehensive depictions of an individual's coagulation profile. VEM are increasingly being integrated into trauma resuscitation guidelines to provide dynamic and individualized guidance to correct coagulopathy.
Study Design And Methods: We performed a narrative review of the search terms viscoelastic, thromboelastography, thromboelastometry, TEG, ROTEM, trauma, injury, resuscitation, and coagulopathy using PubMed. Particular focus was directed to articles describing algorithms for management of traumatic coagulopathy based on VEM assay parameters.
Results: Our search identified 16 papers with VEM-guided resuscitation strategies in adult patients based on TEG, 12 such protocols in adults based on ROTEM, 1 protocol for children based on TEG, and 2 protocols for children based on ROTEM.
Conclusions: This review presents evidence to support VEM use to detect traumatic coagulopathy, discusses the role of VEM in trauma resuscitation, provides a summary of proposed treatment algorithms, and discusses pending questions in the field.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/trf.16074 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictive Factors for 24-h Survival After Perioperative Cardiopulmonary Resuscitation: Single-Center Retrospective Cohort Study.
J Clin Med
January 2025
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Intavarorote Rd., Muang Chiang Mai District, Chiang Mai 50200, Thailand.
Perioperative cardiac arrest (POCA) remains a major challenge in surgical settings, with low survival after cardiopulmonary resuscitation (CPR). This study aims to identify predictive factors for 24 h survival after CPR and cause of POCA. A retrospective, single-center study was conducted on patients aged ≥18 years who experienced POCA and received CPR in the operating room or within 2 h postoperatively at Chiang Mai University Hospital from 2010 to 2019.
View Article and Find Full Text PDFIncreasing Serious Illness Conversations in Patients at High Risk of One-Year Mortality Using Improvement Science: A Quality Improvement Study.
Healthcare (Basel)
January 2025
Department of Medicine, Division of Geriatrics and Palliative Medicine, Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA 23508, USA.
Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores.
View Article and Find Full Text PDFPenetrating Orbital Injury: A Narrative Review for Emergency Clinicians.
Healthcare (Basel)
January 2025
Emergency Department, CHU UCL Namur, 5530 Yvoir, Belgium.
Penetrating orbit injury is a rare but complex and life-threatening occurrence that may easily be overlooked. Management in the emergency department requires an early multidisciplinary approach but still lacks standard guidelines. This narrative review aims to provide a systematic approach to the management of penetrating orbital injuries for emergency clinicians.
View Article and Find Full Text PDFContinuous renal replacement therapy with cytokine-adsorbing hemofilter to control resuscitative endovascular balloon occlusion of the aorta-related ischemia-reperfusion injury in a swine hemorrhagic shock model.
Eur J Trauma Emerg Surg
January 2025
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, 260-8677, Japan.
Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is beneficial for uncontrollable torso bleeding; however, prolonged REBOA causes ischemia-reperfusion injury. The purpose of this study is to examine the hypothesis that continuous renal replacement therapy (CRRT) with a cytokine-adsorbing hemofilter would improve mortality due to hemorrhagic shock with REBOA-reperfusion injury by controlling metabolic acidosis, hyperkalemia, and hypercytokinemia.
Methods: Hemorrhagic shock with 40% blood loss was induced by phlebotomy in eight female swine.
Pre-injury narcotic drug use in isolated severe traumatic brain injury: effect on outcomes.
Eur J Trauma Emerg Surg
January 2025
Division of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Los Angeles, CA, 90033, USA.
Purpose: The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients.
Methods: ACS TQIP study included adult trauma patients (≥ 16 years) with complete drug and alcohol screening. Isolated severe TBI was defined as head trauma with AIS 3-5 and without significant extracranial trauma.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!