Abstract
Development of coagulopathy in severely traumatized patients is a serious and life threatening problem. Its detection must rely on subjective determinations by the operative team. Traditional coagulation test such as the PT and PTT are insensitive, non-specific and take too long to be useful for intra operative decision making. We hypothesized that the ACT would reflect the global coagulation status of acutely traumatized patients. It was expected that the ACT would rise above normal in patients whose coagulation system was nearing exhaustion, based on the traditional mechanisms. By measuring the ACT intra operatively in 31 patients undergoing emergency surgery for trauma, we discovered a correlation between elevated ACT and the development of clinical coagulopathy. The ACT may provide an objective, rapid, inexpensive assay for the early detection of traumatic coagulopathy. It may thus serve as an adjunct to clinical acumen for supporting intra operative decisions to invoke damage control maneuvers and guide volume resuscitation.