Disseminated Intravascular Coagulation in Vascular Trauma
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A principal function of the vascular system is to maintain structural integrity to allow for normal physiologic activity. Insults to this delicate framework due to various forms of traumatic injury severely disrupt the dynamic homeostatic environment of the vascular and hematologic systems, resulting in physiologic derangements – not only within the local setting, but also within the global host environment. Disruption of vessel architecture often manifests as either hemorrhage or thrombosis, which leads to subsequent shock and ischemia. The resulting shift in homeostasis places physiologic stress on nearly every organ system in the body, including the system of coagulation. Corrective maneuvers employed by clinicians addressing hemorrhage and coagulopathy intend to restore normal function of coagulation and while doing so can often simultaneously lead to undesired deleterious effects. This chapter discusses the normal balance of the vascular and hematologic systems, describe the local and systemic sequelae of vascular trauma in reference to coagulation, and review the therapies utilized for treating disturbances in coagulation.
KeywordsHemorrhagic Shock Fibrin Deposition Hematologic System Vascular Trauma Ongoing Hemorrhage
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