Role of prothrombin complex concentrate in the severe trauma patient.

Abstract

Traumatic hemorrhagic shock causes an estimated annual loss of more than 75 million years of life globally, and mostly affects young people (1). It is a time-dependent process, in which prehospital and emergency interventions must be sufficient to prevent the lethal triad of hypothermia, acidosis, and coagulopathy (2), and to avoid trauma-induced coagulopathy (TIC). Both are key determinants of trauma-associated mortality, so early control is essential to improve prognosis and reduce this outcome (3). During hemorrhagic shock, special attention needs to be paid to hyperfibrinolysis and deficiency of coagulation factors. The latter may be deficient for various reasons, such as loss due to hemorrhage, dilution due to vigorous fluid resuscitation, or the activation of pathophysiological mechanisms in TIC that mediate dysfunctionTraumatic hemorrhagic shock causes an estimated annual loss of more than 75 million years of life globally, and mostly affects young people (1). It is a time-dependent process, in which prehospital and emergency interventions must be sufficient to prevent the lethal triad of hypothermia, acidosis, and coagulopathy (2), and to avoid trauma-induced coagulopathy (TIC). Both are key determinants of trauma-associated mortality, so early control is essential to improve prognosis and reduce this outcome (3). During hemorrhagic shock, special attention needs to be paid to hyperfibrinolysis and deficiency of coagulation factors. The latter may be deficient for various reasons, such as loss due to hemorrhage, dilution due to vigorous fluid resuscitation, or the activation of pathophysiological mechanisms in TIC that mediate dysfunction