Acute Traumatic Coagulopathy: Initiated by Hypoperfusion: Modulated Through the Protein C Pathway?

By K. Brohi, M. Cohen, M. Ganter, Michael A. Matthay, R. Mackersie, J. Pittet. Annals of Surgery, 2007

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The coagulopathy of trauma: a review of mechanisms. (2008, methodology): “A base deficit greater than six was associated with coagulopathy in a quarter of patients in one large study.(20) Contrary to historic teaching, platelet counts are generally unaffected.”
Management of bleeding and coagulopathy following major trauma: an updated European guideline (2013, background): “cit >6 mE/l) [9,309] and is characterised by an up-regulation of endothelial thrombomodulin, which forms”
Management of bleeding following major trauma: an updated European guideline (2010, background): “Rationale Major trauma results not only in bleeding from anatomical sites but also frequently in coagulopathy, which is associated with a several-fold increase in mortality [3,5,8,9,245].”
Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. (2008, methodology): “When present in excess, activated protein C is a potent inhibitor of PAI-1(4) and we have previously shown that patients in shock have low levels of PAI-1 and a direct correlation between protein C and PAI-1 levels, suggesting that protein C activation leads to PAI-1 consumption.(3) It has previousl”