Combination of hypothermia, acidosis, and coagulopathy
Medical diagnostic method
Trauma triad of death Triad of death
The trauma triad of death is a medical term describing the combination of hypothermia , acidosis , and coagulopathy .[ 1] This combination is commonly seen in patients who have sustained severe traumatic injuries and results in a significant rise in the mortality rate .[ 2] Commonly, when someone presents with these signs, damage control surgery is employed to reverse the effects.[citation needed ]
The three conditions share a complex relationship; each factor can compound the others, resulting in high mortality if this positive feedback loop continues uninterrupted.[citation needed ]
Severe bleeding in trauma diminishes oxygen delivery , and may lead to hypothermia . This in turn can halt the coagulation cascade , preventing blood from clotting . In the absence of blood-bound oxygen and nutrients (hypoperfusion ), the body's cells burn glucose anaerobically for energy, causing the release of lactic acid , ketone bodies , and other acidic compounds into the blood stream, which lower the blood's pH , leading to metabolic acidosis . Such an increase in acidity damages the tissues and organs of the body and can reduce myocardial performance , further reducing the oxygen delivery.[citation needed ]
References
^ Rotondo, Michael F.; Zonies, David H. (Aug 1997), "The damage control sequence and underlying logic", Surgical Clinics of North America , 44 (7): 761–777, doi :10.1016/S0039-6109(05)70582-X , PMID 9291979
^ Lewis, Anne Marie (Mar 2000), "Trauma triad of death emergency", Nursing , 30 (3): 62–4, doi :10.1097/00152193-200030030-00028 , PMID 11000823
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