Procoagulant activity in patients with isolated severe head trauma

Critical Care Medicine
R U Scherer, P Spangenberg

Abstract

To determine the degree of regional and systemic coagulation activation soon after isolated severe head injury. Prospective, controlled clinical study. The emergency room and intensive care unit (ICU) of a trauma center in a university hospital serving a population of 5 million people. Twenty-four trauma victims: 20 patients with isolated severe head injury (head trauma group, Glasgow Coma Score of < or =8) and four patients with isolated bone fracture (control group). Insertion of central venous, i.e. superior caval vein, jugular bulb, and arterial catheters for blood sampling. Central venous (i.e., superior caval vein) global coagulation variables (i.e., prothrombin time, activated partial thromboplastin time, fibrinogen concentration, antithrombin III activity, and platelet count) and central venous and jugular bulb activation coagulation and fibrinolysis variables (i.e., prothrombin fragment F1+2, thrombin-antithrombin III complex, soluble fibrin, and D-dimer concentration) were measured soon after trauma (<6 hrs) and 3 hrs later. When compared with the control group patients, upon ICU admission, fibrinogen concentration (p < .005) and platelet count (p < .025) were significantly decreased in the head trauma group. Thrombin...Continue Reading

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