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Review Article
- Trauma
- Hemostatic resuscitation in patients with trauma-induced coagulopathy: a narrative review
- Junsik Kwon, Byung Hee Kang
- Acute Crit Care. 2026;41(1):47-57. Published online January 20, 2026
- DOI: https://doi.org/10.4266/acc.003525
- 7,223 View
- 716 Download
- 2 Web of Science
- 2 Crossref
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Abstract
PDF - Hemorrhage remains a leading cause of preventable death in trauma, emphasizing the importance of early bleeding control. In addition to mechanical hemostasis, effective management of trauma-induced coagulopathy (TIC) plays a critical role in improving outcomes. TIC is a multifactorial condition with diverse phenotypes, involving complex pathophysiology. These variations complicate early diagnosis and targeted treatment. In the prehospital setting, phenotype-based management is not feasible; thus, empirical strategies have been adopted. Administration of tranexamic acid and prehospital whole blood transfusion have shown clinical benefit in selected trauma populations. Upon hospital arrival, fixed-ratio massive transfusion protocols and whole blood resuscitation provide broad support for coagulopathic states and have proven effective in reducing early mortality. However, these approaches may not fully account for individual variation in coagulation profiles. Viscoelastic assays allow real-time evaluation of coagulation status and offer the potential for individualized, goal-directed therapy. While some studies suggest improved outcomes with viscoelastic-guided resuscitation, evidence of clear superiority over conventional methods remains limited. Further research is needed to determine the optimal resuscitation strategy and integrate both empirical and precision-based approaches in TIC management.
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Citations
Citations to this article as recorded by
- Management of trauma‐induced coagulopathy in the perioperative setting: What is the role of anesthesia?
Angela M. Mitchell, Brennah C. O'Connell, Valerie G. Sams
Transfusion.2026;[Epub] CrossRef - N-Acetylcysteine Attenuates Oxidative Stress and Preserves Red Blood Cell Quality During Whole Blood Storage
Sonia Eligini, Lisa Brocca, Alice Mallia, Arianna Valeriano, Erica Gianazza, Cristina Banfi
Antioxidants.2026; 15(7): 858. CrossRef
- Management of trauma‐induced coagulopathy in the perioperative setting: What is the role of anesthesia?
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