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For people berween the ages of 5 and 45, trauma is second only to HIV/AIDS as a cause of death. Every year, over three million people worldwide, die as a result of trauma, many after reaching hospital (1). Among trauma patients who do survive and reach hospital, exsanguination is a common cause of death, accounting for nearly half of in-hospital trauma deaths (2). Central nervous system injury and multi-organ failure account for most of the remainder, both of which can be exacerbated by severe bleeding (3). The haemostatic system helps maintain the integrity of the circulatory system after severe vascular injury, whether traumatic or surgical in origien (4). Major surgery and trauma trigger similar haemostatic responses and any consequent massive blood loss presents an extreme challenge to the coagulation system. Part of the response to surgery and trauma, in any patient, is stimulation of clot breakdown (fibrinolysis) which may become pathological (hyperfibrinolysis) (4). Anti-fibrinolytic agents have been shown to reduce blood loss in patients with both normal and exaggerated fibrinolytic responses to surgery, and do so without apparent increase to the risk of postoperative complications, most notably there is no increased risk of venous thromboembolism (5).

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2005-05-19   |   717 visitas   |   Evalua este artículo 0 valoraciones

Vol. 16 Núm.1. Enero-Marzo 2005 Pags. 69-70 Rev Biomed 2005; 16(1)