Comparison of disseminated intravascular coagulation in trauma with coagulopathy of trauma/acute coagulopathy of trauma-shock

摘要

Disseminated intravascular coagulation (DIC) has been considered to be one of the main pathogenetic features of traumatic coagulopathy for over three decades [1]. It involves a dynamic imbalance of coagulation, anticoagulation and fibrinolytic pathways with distinct phenotypes induced by trauma. During the early phase of trauma, DIC has a fibrinolytic phenotype, and is associated with hyperfi-brin(ogen)olysis and consumptive coagulopathy, contributing to massive hemorrhage. This type of DIC changes, at later stages of trauma, into DIC with a thrombotic phenotype, which gives rise to organ dysfunction, primarily because of fibrin clot deposition [1]. Therefore, both types of DIC are determinants for the prognosis of severely injured trauma patients.