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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Fries, D. Martini, W. Z. |
| Description | Country affiliation: Austria Author Affiliation: Fries D ( Department of General and Surgical Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, Innsbruck, Austria. dietmar.fries@i-med.ac.at) |
| Abstract | Coagulation defects related to severe trauma, trauma-induced coagulopathy (TIC), have a number of causal factors including: major blood loss with consumption of clotting factors and platelets, and dilutional coagulopathy after administration of crystalloids and colloids to maintain blood pressure. In addition, activation of the fibrinolytic system or hyperfibrinolysis, hypothermia, acidosis, and metabolic changes can also affect the coagulation system. All of these directly affect fibrinogen polymerization and metabolism. Other bleeding-related deficiencies usually develop later in massive bleeding related to severe multiple trauma. In major blood loss, fibrinogen reaches a critical value earlier than other procoagulatory factors, or platelets. The question of the critical threshold value is presently the subject of heated debate. A threshold of 100 mg dl(-1) has been recommended, but recent clinical data have shown that at a fibrinogen level of <150-200 mg dl(-1), there is already an increased tendency to peri- and postoperative bleeding. A high fibrinogen count exerts a protective effect with regard to the amount of blood loss. In multiple trauma patients, priority must be given to early and effective correction of impaired fibrin polymerization by administering fibrinogen concentrate. |
| File Format | HTM / HTML |
| ISSN | 00070912 |
| e-ISSN | 14716771 |
| Journal | British Journal of Anaesthesia |
| Issue Number | 2 |
| Volume Number | 105 |
| Language | English |
| Publisher | Oxford University Press |
| Publisher Date | 2010-08-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Discipline Anesthesiology Blood Coagulation Disorders Drug Therapy Etiology Coagulants Therapeutic Use Fibrinogen Wounds And Injuries Complications Acidosis Blood Blood Platelets Metabolism Fibrinolysis Fluid Therapy Hypothermia Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine |
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