Details

Autor(en) / Beteiligte

• Moore, Hunter B
• Moore, Ernest E
• Neal, Matthew D
• Sheppard, Forest R
• Kornblith, Lucy Z
• Draxler, Dominik F
• Walsh, Mark
• Medcalf, Robert L
• Cohen, Mitch J
• Cotton, Bryan A
• Thomas, Scott G
• Leeper, Christine M
• Gaines, Barbara A
• Sauaia, Angela

Titel

Fibrinolysis Shutdown in Trauma: Historical Review and Clinical Implications

Ist Teil von

• Anesthesia and analgesia, 2019-09, Vol.129 (3), p.762-773

Ort / Verlag

United States: International Anesthesia Research Society

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Despite over a half-century of recognizing fibrinolytic abnormalities after trauma, we remain in our infancy in understanding the underlying mechanisms causing these changes, resulting in ineffective treatment strategies. With the increased utilization of viscoelastic hemostatic assays (VHAs) to measure fibrinolysis in trauma, more questions than answers are emerging. Although it seems certain that low fibrinolytic activity measured by VHA is common after injury and associated with increased mortality, we now recognize subphenotypes within this population and that specific cohorts arise depending on the specific time from injury when samples are collected. Future studies should focus on these subtleties and distinctions, as hypofibrinolysis, acute shutdown, and persistent shutdown appear to represent distinct, unique clinical phenotypes, with different pathophysiology, and warranting different treatment strategies.