ABSTRACT
Hemorrhagic shock can be compounded by trauma-induced coagulopathy (TIC), which is a hypocoagulable state that can develop immediately after injury and deteriorates with increasing tissue hypoperfusion. TIC is a disease state that includes impairments in clot formation, hemostasis, and ultimate breakdown of the clot due to disorders in both inflammatory and coagulopathic pathways. The rate of trauma patients receiving massive transfusions remains low; however, patients requiring this intervention are at highest risk for TIC. The identification of TIC can be achieved by conventional lab tests, including a platelet count; fibrinogen level; and coagulation assays such as prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR). The major limiting factor with these assays is the time to obtain the results. Accumulating data demonstrate whole blood transfusion can be a potentially lifesaving method of resuscitation in severely injured trauma patients.
