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MedicineAnatomy and Physiology

The Coagulopathy of Trauma: A Review of Mechanisms

Authors: John R. Hess; Karim Brohi; Richard P. Dutton; Carl J. Hauser; John B. Holcomb; Yoram Kluger; Kevin Mackway-Jones; Michael J. Parr; Sandro B. Rizoli; Tetsuo Yukioka; David B. Hoyt; Bertil Bouillon; MARYLAND UNIV BALTIMORE OFFICE OF RESEARCH AND DEVELOPMENT
Abstract:
For the U.S. Military, war-related traumatic injury deaths exceeded 5,000 in the last decade, and many more soldiers and marines have been seriously injured by improvised explosive devices, high-velocity munitions, and vehicular events. These events have brought the problem of the acute coagulopathy of trauma to the fore. The goal of this project was to increase basic knowledge about the coagulopathy specifically associated with severe trauma. Our objectives were to assemble a precise and detailed database on coagulation factor levels over the course of resuscitation of severely injured, hemorrhaging, patients. Our proposed research was to be conducted with a 24 hour delay of informed consent, which was approved by our IRB. The Air Force ultimately denied approval for a delayed consent. The results are thus limited. Nevertheless, we enrolled 15 patients including several who were shot, others who were severely injured in other ways and four who ultimately died. Despite the small number of patients recruited, the demographics and methods of injury were typical of modern American civilian urban Level I trauma center populations.

Limitations: APPROVED FOR PUBLIC RELEASE
Description: Final rept. Jan 2007-Sep 2010
Pages: 8
Report Date: OCT 2008
Contract Number: FA7014-07-C-0039
Report Number: A418445
Keywords relating to this report:
AIR FORCE
AMMUNITION
ARMY PERSONNEL
BLOOD COAGULATION
DATA BASES
DYSFUNCTION
EXPLOSIVE CHARGES
HEMORRHAGE
MARINE CORPS PERSONNEL
PATIENTS
REPRINTS
TRAUMA
WARFARE
WOUNDS AND INJURIES
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