This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Nutritional and Metabolic Disorders  • Nutrition/ Malnutrition  • Blood/ Coagulation  • Genetics  • Genetic Disorders  • Hematology/ Hematologic Malignancies  • Coagulation Disorders  • Alert me on articles by topic

Elliott R. Haut, MD

Arch Surg. 2008;143(8):802.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

When I first started reading "Trauma and Coagulopathy: A New Paradigm to Consider" by MacLeod, I was skeptical. I liked the "old" paradigm. Most trauma surgeons accept the theory that trauma-associated coagulopathy is a secondary phenomenon. Bleeding leads to coagulopathy, hypothermia, and acidosis, which make up the "lethal triad." As each of these 3 components worsens after major trauma, they exacerbate one another and patients begin a downward spiral known as the "bloody vicious cycle." The concept of abbreviated "damage-control" surgery to stop this sequence before irreversible physiologic exhaustion is the current tactic in cases of exsanguinating trauma. This approach makes intuitive sense and has been a way of life for my entire surgical career. It is a framework to educate fellows, residents, students, and staff in the clinical treatment of severely injured patients at trauma centers across around the world.

However, on further consideration, I . . . [Full Text of this Article]

AUTHOR INFORMATION

RELATED ARTICLE

Trauma and Coagulopathy: A New Paradigm to Consider
Jana B. A. MacLeod
Arch Surg. 2008;143(8):797-801.
EXTRACT | FULL TEXT