ABSTRACT
A hypercoagulable state represents a clinical condition characterized by a tendency to thrombosis, associated with specific changes affecting hemostasis. In trauma patients, the observed changes in the blood might be seen as favoring hemostasis. The immediate function of the hemostatic mechanism is the termination of blood loss from the intravascular space. In the trauma patient the three classical elements of Virchow’s triad are present: vascular endothelial damage, stasis, and hypercoagulability. Tissue trauma activates proteolysis in different humoral systems: coagulation, fibrinolysis, kallikrein, and complement. Trauma patients are evaluated usually according to an injury severity score which is categorized by body area and severity. The presence of acute respiratory distress syndrome in patients with polytrauma has been related to intravascular coagulation and fibrinolysis inhibition. Abnormal coagulation and fibrinolysis is a frequent complication in patients with head injury. Conventional means of anticoagulant prophylaxis are not always suitable in the trauma patient, because of the risk of hemorrhagic complications.
