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Blood Failure: Pathophysiology and Diagnosis

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Damage Control Resuscitation

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Abstract

Hemorrhage is the leading cause of preventable death in both civilian and military environments. It is now known that impaired coagulation in the setting of traumatic shock that increases hemorrhage has been identified in 20–30% of trauma victims shortly after injury and when present can increase the incidence of organ failure, intensive care utilization, and even death. New insights into the field of traumatic shock have led to a recent and growing concept that blood and its endothelial interface should be considered an organ system and that when injured sufficiently can fail. This chapter will define the critical elements and pathophysiology of trauma-induced hemorrhagic blood failure including the physiology of shock and oxygen debt, reperfusion injury, the role of the endothelium, and resulting hemostatic dysfunction including its diagnosis. This framework will assist in understanding the process by which blood failure develops and also offer a base from which to work to develop new prevention, diagnostic, and treatment strategies for blood failure as they apply to the challenges of remote damage control resuscitation and other settings.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Washington, Seattle, WA, USA

    Nathan J. White

  2. Departments of Emergency Medicine and Biomedical Engineering, Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, USA

    Kevin R. Ward

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  1. School of Medicine, Washington University in St. Louis, St. Louis, MO, USA

    Philip C. Spinella

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White, N.J., Ward, K.R. (2020). Blood Failure: Pathophysiology and Diagnosis. In: Spinella, P. (eds) Damage Control Resuscitation. Springer, Cham. https://doi.org/10.1007/978-3-030-20820-2_3

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