Understanding the pathophysiology and establishing the therapeutic strategy for trauma-induced coagulopathy in patients with severe trauma

2015 Fiscal Year Final Research Report

• Project/Area Number: 25462810
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Emergency medicine
• Research Institution: Tohoku University
• Principal Investigator: Kushimoto Shigeki 東北大学, 医学(系)研究科(研究院), 教授 (50195434)
• Co-Investigator(Kenkyū-buntansha): YAMANOUCHI SATOSHI 東北大学, 大学院医学系研究科, 講師 (00307638) ; YAMADA MITSUHIRO 東北大学, 大学院医学系研究科, 助教 (00396483) ; FURUKAWA HAJIME 東北大学, 病院, 助教 (30624853) ; KUDO DAISUKE 東北大学, 大学院医学系研究科, 助教 (30455844)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 外傷 / 血液凝固異常 / 集中治療 / ダメージ関連分子パターン

Outline of Final Research Achievements

Hemorrhage is the most important contributor of acute-phase mortality in trauma patients, and coagulopathy is present at the time of admission in 25% of patients. Understanding the pathophysiology of coagulopathy and establishing the therapeutic strategy are the critical issue for the management of patients with severe trauma.
We revealed that mitochondrial DNA, one of alarmins, play an important role in the pathophysiology of inflammatory, coagulation response, leading to organ dysfunction syndrome, in patients with severe trauma. We also demonstrated that administration of tranexamic acid within 3 hr of injury, and high plasma/red blood cell transufusion ratio within 6 hr may contribute to decreasing mortality in patients with severe trauma from multi-institutional observational study.
Trauma-induced coagulopathy is multifactorial,and is definitively the most important issue for the management of severe trauma patients. Our findinsg may provide new aspects for this critical issue.

Free Research Field

救急医学、集中治療医学、外科学