Postinjury coagulopathy management in damage control sugery        LI Ning. Clinical School of Medical College,  Nanjing University, Research Institute of General Surgery, Nanjing General Hospital of Nanjing Command, Nanjing210002, China
Abstract    Postinjury coagulopathy remains one of the fundamental rationale for damage control surgery and the exact mechanism remains to be clarified. Recently, the classic description of the intrinsic and extrinsic coagulation cascades has recently been revised by the “cell-based model” of coagulation. The new innovation of coagulation has changed the testing and management of coagulation disorders. As modeling in vivo coagulation, thromboelastography (TEG) is the only single test that can provide information on the balance between thrombosis and lysis, while the traditional coagulation tests, including PT, APTT and so on are based on isolated, static end points. And TEG could be more accurate and rapid. Compared with current resuscitation protocol such as transfusion of fresh-frozen plasma and packed red blood cells in a certain ration, component blood product therapy guided by TEG enables timely correction of coagulation dysfunction, reduction of transfusion volumes and improvement in survival. Furthermore, using recombinant activated factor VII properly would be effectively hemostatic properties in patients with uncontrolled hemorrhage refractory.