TIC

Q: Trauma-induced coagulopathy (TIC) is due to 

A) acidosis 

B) hypothermia 

C) hemodilution 

D) none of the above

Answer: D

There are multiple etiologies for coagulopathy in trauma patients like acidosis, hypothermia, or hemodilution. Besides this 'vicious triad' (choices A, B, and C) trauma itself and  'independently' can lead to coagulopathy, and is called Trauma-Induced Coagulopathy (TIC). 

 

This is multifactorial and due to a direct biochemical response to tissue injury and shock. Mechanisms include dysregulated coagulation, altered fibrinolysis, systemic endothelial dysfunction, inflammatory responses to injury, and platelet dysfunction.

#trauma

#hematology

References:

1. Moore HB, Gando S, Iba T, et al. Defining trauma-induced coagulopathy with respect to future implications for patient management: Communication from the SSC of the ISTH. J Thromb Haemost 2020; 18:740. 

2. Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. J Trauma 2003; 54:1127. 

3. Chang R, Cardenas JC, Wade CE, Holcomb JB. Advances in the understanding of trauma-induced coagulopathy. Blood 2016; 128:1043. 

4. Hess JR, Brohi K, Dutton RP, et al. The coagulopathy of trauma: a review of mechanisms. J Trauma 2008; 65:748.