The trauma triad of death: hypothermia, acidosis, and coagulopathy.

@article{Mikhail1999TheTT,
  title={The trauma triad of death: hypothermia, acidosis, and coagulopathy.},
  author={Judy N. Mikhail},
  journal={AACN clinical issues},
  year={1999},
  volume={10 1},
  pages={
          85-94
        }
}
  • J. Mikhail
  • Published 1 February 1999
  • Medicine
  • AACN clinical issues
With the organization of trauma systems, the development of trauma centers, the application of standardized methods of resuscitation, and improvements in modern blood banking techniques, the ability to aggressively resuscitate patients in extremis has evolved. The concept of the "golden hour" has translated into unprecedented speed and efficiency of trauma resuscitation with the ultimate goal of short injury-to-incision times. As the shift in care of patients in extremis has continued to move… 
Hypothermia in Trauma
TLDR
This narrative review describes the main factors to consider in the co-existing condition of trauma and hypothermia from a prehospital and emergency medical perspective.
Coagulopathies in trauma patients.
TLDR
The relevant pathophysiology as it relates to the development of a coagulopathy, prevention strategies, and management principles applied in caring for the patient with trauma and a coaggulopathy are described.
What's new in emergencies, trauma, and shock: Intentional or accidental hypothermia in Intensive Care Unit patients: Time to strike the colors?
The study of Balvers et al. once more underpins that trauma-associated hypothermia is far from being a physiological adaptation mechanism to protect the body from ongoing harmful stress but rather a
Damage Control Resuscitation
TLDR
The strategies that makeup DCR, their adjuncts, and how they fit into the care of the hemorrhaging patient are discussed.
Hypovolemic shock: an overview.
TLDR
Shock encountered in trauma victims: hypovolemic, cardiogenic, obstructive, and distributive shock is discussed, with emphasis on hypovolesmic shock and its sequelae.
Damage Control Resuscitation Across the Phases of Major Injury Care
TLDR
This review details central components of damage control resuscitation (DCR) across the phases of major injury care and the evidence behind its adoption.
Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations
TLDR
A retrospective cohort study of trauma patients admitted to five international trauma centers and corroborated the findings in a novel rat model of ATC, finding that ATC develops endogenously in response to a combination of tissue damage and shock.
HYPOVOLIMIC SHOCK: QUANTIFYING THE RISK OF HYPOTENSION AND HYPOTHERMIA IN SEVERELY INJURED TRAUMA PATIENTS
TLDR
A brief episode of hypotension during ICU day one was associated with increased mortality and mortality, and for patients who survived ICu day one, hypotension in ICUDay two predicts the outcome better than hypotension records of ICUday one.
Tactical damage control resuscitation in austere military environments
TLDR
In tactical situations, in association with haemostatic procedures (tourniquet, suture, etc), tranexamic acid should be the first medication used according to the current guidelines in relation to trauma-induced coagulopathy treatment and far-forward transfusion.
Damage control surgery for abdominal trauma.
TLDR
Evidence that supports the efficacy of damage control surgery with respect to traditional laparotomy in patients with major abdominal trauma is limited, and two studies were excluded with reasons after examining the full-text.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 26 REFERENCES
Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited.
TLDR
Postinjury life-threatening coagulopathy in the seriously injured requiring massive transfusion is predicted by persistent hypothermia and progressive metabolic acidosis.
Immediate trauma resuscitation with type O uncrossmatched blood: a two-year prospective experience.
TLDR
It is concluded that for immediate trauma resuscitation, TOB is safe and TOB has additional advantages over TSB or Type O whole blood transfusion.
Massive blood loss in trauma patients.
TLDR
The authors summarize the basic principles of patient evaluation and care in emergency situations and describe some adverse consequences of massive transfusions and present tips on how to avoid or minimize them.
Autotransfusion of blood contaminated by enteric contents: a potentially life-saving measure in the massively hemorrhaging trauma patient?
TLDR
It may be appropriate to use autotransfusion of shed blood in trauma patients with gastrointestinal injuries, if banked blood is not readily available and the patients receive perioperative broad-spectrum antibiotics.
Survival after massive transfusions exceeding four blood volumes in patients with blunt injuries.
TLDR
The authors' experience with 29 patients with blunt injuries who sustained massive transfusions exceeding four blood volumes in the initial posttraumatic 12 hours was reviewed and strongly promote the importance of initial volume resuscitation.
Changes in red cell transfusion practice among adult trauma victims.
TLDR
Between 1991 and 1995 there have been significant reductions in both the number of trauma patients receiving blood products and the total number of units transfused, which may reflect lower or abandoned hemoglobin transfusion triggers and increased awareness of complications related to transfusion.
Epidemiology of Trauma Deaths
TLDR
There was an improved access to the medical system, greater proportion of late deaths due to brain injury and lack of the classic trimodal distribution, in the Denver City and County trauma system during 1992.
Admission base deficit predicts transfusion requirements and risk of complications.
TLDR
This study found that admission BD identifies patients likely to require early transfusion and increased ICU and hospital stays, and be at increased risk for shock-related complications.
Autotransfusion of potentially culture-positive blood (CPB) in abdominal trauma: preliminary data from a prospective study.
TLDR
Washed CPB may be autotransfused without significantly increased risk of infection in patients with severe abdominal injuries, and bacteremias, pulmonary infections, and urinary infections were not caused by bacteria cultured from autotranfused blood.
Practice Guidelines for Blood Component Therapy: A Report by the American Society of Anesthesiologists Task Force on Blood Component Therapy
TLDR
The principal conclusions of the task force are that red blood cell transfusions should not be dictated by a single hemoglobin "trigger" but instead should be based on the patient's risks of developing complications of inadequate oxygenation.
...
1
2
3
...