An ACT is characterized by a disrupted equilibrium between procoagulant, anticoagulant, and fibrinolytic systems, triggered by the upregulation and release of endogenous mediators. Early on, the ACT phenotype is one of a hypercoagulable state that is often exacerbated by acidosis, hypothermia, and dilution of procoagulants with aggressive crystalloid/colloid resuscitation. With ongoing tissue injury and shock, DIC and fibrinolysis can occur; therefore, prompt treatment of hypoperfusion is essential for survival.

References

• Brohi K, Singh J, Heron M, et al. Acute traumatic coagulopathy. J Trauma. 2003;54:1127-1130.
• Moore EE, Moore HB, Kornblith LZ, et al. Trauma-induced coagulopathy. Nat Rev Dis Primers. 2021;7:30.