Update on the pathophysiology and management of acute trauma hemorrhage and traumainduced coagulopathy (TIC) based upon viscoelastic testing (VET).

Abstract

Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) remain the two predominante causes of preventable death after trauma. Early control of bleeding sources along with rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of acute trauma hemorrhage and TIC even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing (VET) for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC.