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Fibrinolysis Dysregulation Following Trauma

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Trauma Induced Coagulopathy

Abstract

Derangement of fibrinolysis has been an interest of surgical scientists for over 200 years. Appreciation of the spectrum of fibrinolysis following severe injury confirms the long-perceived notion that pathology occurs at the extremes of any protease system. Trauma can provoke overactivation of fibrinolysis resulting in uncontrolled bleeding or inhibition resulting in fibrinolysis shutdown resulting in organ dysfunction. While the CRASH II trial demonstrated a modest benefit in survival using antifibrinolytic medication in trauma patients, there are likely superior resuscitation strategies to improve survival in patients with abnormal fibrinolytic activity. This chapter is intended to refresh the reader’s historic appreciation of trauma-induced fibrinolysis and emphasize the physiologic role of the fibrinolytic system in response to injury.

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Authors and Affiliations

  1. Department of Surgery, University of Colorado, Aurora, CO, USA

    Hunter B. Moore

  2. Department of Surgery, University of Colorado Denver, Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO, USA

    Ernest E. Moore

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  1. Hunter B. Moore
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  2. Ernest E. Moore
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Correspondence to Ernest E. Moore .

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Editors and Affiliations

  1. Department of Surgery, University of Colorado, Aurora, CO, USA

    Hunter B. Moore

  2. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Matthew D. Neal

  3. Department of Surgery, University of Colorado Denver, Ernest E Moore Shock TraumaCenter at Denver Health, Denver, CO, USA

    Ernest E. Moore

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Moore, H.B., Moore, E.E. (2021). Fibrinolysis Dysregulation Following Trauma. In: Moore, H.B., Neal, M.D., Moore, E.E. (eds) Trauma Induced Coagulopathy. Springer, Cham. https://doi.org/10.1007/978-3-030-53606-0_11

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