Figure 1.

Possible mechanisms of acute traumatic coagulopathy.

Besides dilution coagulopathy, hemorrhage induces shock, followed by acidosis and hypothermia, and this “lethal triad” reinforces the coagulopathy. Moreover, the traumatic shock leads to hypoperfusion and hypoxia and further aggravates the coagulopathy via consumption of coagulation materials and hyperfibrinolysis. The role of inflammation in the development of acute traumatic coagulopathy has not yet been completely clarified (modified from [3]). In the summarized TR-DGU data, acute traumatic coagulopathy was independently associated with severity of injury (ISS), prehospital volume replacement, body temperature ≤35°C, and shock status (4).