How does trauma cause coagulopathy?

How does trauma cause coagulopathy?

Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction.

What are some common complications of head injury in trauma patients?

Physical complications

• Seizures. Some people with traumatic brain injury will develop seizures.
• Fluid buildup in the brain (hydrocephalus).
• Infections.
• Blood vessel damage.
• Headaches.
• Vertigo.

Can TBI cause DIC?

Disseminated intravascular coagulation was present in 32.3% of patients with severe TBI [1]. More recent data provides similar incidence, with coagulopathy present in 10% to 90% of TBI patients during their hospital course; most studies have been retrospective series [6-8].

What causes coagulopathy?

Coagulopathy may be caused by reduced levels or absence of blood-clotting proteins, known as clotting factors or coagulation factors. Genetic disorders, such as hemophilia and von Willebrand’s disease, can cause a reduction in clotting factors.

What can cause an acquired coagulopathy in pregnancy?

The patient may have developed a coagulopathy acutely secondary to hemodilution, disseminated intravascular coagulation (DIC), or ALFP (Acute Fatty Liver of Pregnancy) Additional reasons for postpartum hemorrhage include placenta accreta, HELLP syndrome and amniotic fluid embolism.

What are the two classifications of traumatic brain injury?

Classification as Primary or Secondary injury Primary injury is induced by mechanical force and occurs at the moment of injury. Secondary injury is not mechanically induced. It may be delayed from the moment of impact, and it may superimpose injury on a brain already affected by a mechanical injury.

What are the long term effects of head trauma?

The long-term effects of mild traumatic brain injury can be anything but mild. Migraines, dizziness, depression, and cognitive impairments are just a few of the secondary effects that may accompany a mild TBI. They can last for months, and sometimes even years post-injury.

What are the stages of DIC?

DIC progresses through three continuous, overlapping stages: Hypercoagulation: Not noted clinically. Compensated or subclinical stage: May see alterations in coagulation profiles or end-organ dysfunction. Fulminant or uncompensated stage: Fulminant coagulopathy and signs of hemorrhage.

What can cause DIC?

Causes

• Blood transfusion reaction.
• Cancer, especially certain types of leukemia.
• Inflammation of the pancreas (pancreatitis)
• Infection in the blood, especially by bacteria or fungus.
• Liver disease.
• Pregnancy complications (such as placenta that is left behind after delivery)
• Recent surgery or anesthesia.

What is classification of head injury?

Head injuries may be categorized in several ways. Injuries are classified by mechanism (closed vs. penetrating injury), morphology (fractures, focal intracranial injury and diffuse intracranial injury), and severity (mild, moderate and severe).

What is a remote TBI?

Remote moderate-to-severe TBI is a risk factor for motor dysfunction—defined as recent falls and impaired posture/gait—among older veterans. TBI-exposed older adults may be ideal candidates for aggressive fall-screening and prevention strategies.

Is it common for trauma to cause coagulopathy?

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy.

What makes brain tissue prone to coagulopathy?

Studies in the past have shown that brain tissue is highly enriched in key procoagulant molecules. This review focuses on the biochemical and cellular characteristics of these molecules and pathways that could make brain uniquely procoagulant and prone to coagulopathy.

When does a patient have a trauma score?

Conventionally, trauma is defined as severe when the patient’s injury severity score (ISS) exceeds 15. ISS is an assessment system that assigns a number based on the severity and location of the different injuries caused by trauma.

What happens to blood clotting cells after trauma?

Acidosis is a frequent and early event in patients after trauma that results from inadequate tissue oxygenation, which then activates anaerobic metabolism. Acidosis itself causes plasma protein dysfunction and leads to the rapid degradation of fibrinogen, and almost all stages of clotting are compromised in this setting.