Coagulopathy is frequent present in trauma. Acute coagulopathy associated with trauma (ACoT) has been recognized as a distinct entity associated with increased mortality, morbidity and transfusion requirements. Uncontrolled bleeding is the most frequent preventable cause of death in trauma patients reaching hospital alive. Coagulopathy in trauma has been long thought to develop as a result of hemodilution, acidosis and hypothermia often related to resuscitation practices. The lack of well defined diagnosis criteria for ACoT impedes early identification and treatment. Prolongation of prothrombin time (PT) and activated thromboplastine time (APTT) have been used by most author to diagnosis ACoT. Mechanisms contributing to ACoT include anticoagulation, consumption, platelet dysfunction and hyperfibrinolysis. Early administration of tranexamic acid ,recombinant factor Ⅶ and aggressive blood product transfusional management for ACoT with a red blood cell: plasma: platelets ratio close to 1:1:1 could result in decreased mortality from uncontrolled bleeding. This article will review the pathophysiology and management of ACoT.

Acute coagulopathy associated with trauma (ACoT); tranexamic acid; recombinant factor VII