[Perioperative coagulation management controlled by thrombelastography. Clinical implementation illustrated by reference to a case of acquired coagulopathy following aortic stab injury]. / Durch Thrombelastographie gesteuertes perioperatives Gerinnungsmanagement. Klinische Umsetzung am Beispiel einer erworbenen Koagulopathie nach aortaler Stichverletzung.

Uncontrolled bleeding is one of the main reasons for a lethal outcome of severe trauma. Loss, consumption and dilution of clotting factors and platelets induce a complex acquired coagulopathy. Beside surgical control of bleeding, early and precise coagulation therapy is essential for successful treatment. We report on a patient whose life-threatening bleeding and perioperative coagulopathy after a knife injury to the aorta was successfully treated by surgical control of the bleeding and subsequent targeted coagulation therapy with factor concentrates and fresh-frozen plasma. The coagulopathy was diagnosed and managed by means of bed-side thrombelastography.