Modern aspects of pathophysiology and hemostatic disorders in patients with polytrauma

O.O. Tarabrin, V.O. Ivanova


In recent decades, despite the significant achievements of surgery, traumatology, anaesthesiology and resuscitation, in Ukraine, as well as almost all over the world, there is a significant increase in the level, severity and mortality under traumatic injuries that has allowed some authors to introduce the concept of an epidemic of injuries. An increased number of injuries to vital organs, the high production and material costs, which are spent on prevention, diagnosis, treatment and rehabilitation of patients with traumatic disease, give this issue a special urgency and a great social and medical significance. The primary disorder under all critical conditions is the dysregulation of oxygen exchange between blood and tissues. State of prolonged hypoxia becomes a factor of progressive inhibition of energy-dependent processes responsible for the structural maintenance of intracellular reactions. In patients with polytrauma, acute coagulopathy develops independently of the volume of blood loss. Thus, polytrauma is pathology with corresponding specific changes in all systems of damaged body and development of traumatic disease, which occurs over a long period of time. Half of the lethal cases after traumatic lesions are associa­ted with bleeding, and most of them occur within 6 hours after injury. It is shown that hemorrhagic shock after trauma induces dysfunction of the hemostasis system within a few minutes, and this early trauma-induced coagulopathy can exacerbate blee­ding and is associated with a higher mortality and morbidity.


polytrauma; hemostasis; coagulopathy


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