“COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit
IntroductionCoagulopathy associated with isolated traumatic brain injury (C-iTBI) is a frequent complication associated with poor outcomes, primarily due to its role in the development or progression of haemorrhagic brain lesions. The independent risk factors for its onset are age, severity of traum...
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309094/full |
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| author | Manuel Quintana-Diaz Manuel Quintana-Diaz Manuel Quintana-Diaz Pasquale Anania Raúl Juárez-Vela Raúl Juárez-Vela Raúl Juárez-Vela Emmanuel Echaniz-Serrano Emmanuel Echaniz-Serrano Clara Isabel Tejada-Garrido Clara Isabel Tejada-Garrido Pilar Sanchez-Conde Kapil Nanwani-Nanwani Kapil Nanwani-Nanwani Ainhoa Serrano-Lázaro Ainhoa Serrano-Lázaro Pilar Marcos-Neira María Gero-Escapa Jorge García-Criado Daniel Agustín Godoy |
| author_facet | Manuel Quintana-Diaz Manuel Quintana-Diaz Manuel Quintana-Diaz Pasquale Anania Raúl Juárez-Vela Raúl Juárez-Vela Raúl Juárez-Vela Emmanuel Echaniz-Serrano Emmanuel Echaniz-Serrano Clara Isabel Tejada-Garrido Clara Isabel Tejada-Garrido Pilar Sanchez-Conde Kapil Nanwani-Nanwani Kapil Nanwani-Nanwani Ainhoa Serrano-Lázaro Ainhoa Serrano-Lázaro Pilar Marcos-Neira María Gero-Escapa Jorge García-Criado Daniel Agustín Godoy |
| author_sort | Manuel Quintana-Diaz |
| collection | DOAJ |
| description | IntroductionCoagulopathy associated with isolated traumatic brain injury (C-iTBI) is a frequent complication associated with poor outcomes, primarily due to its role in the development or progression of haemorrhagic brain lesions. The independent risk factors for its onset are age, severity of traumatic brain injury (TBI), volume of fluids administered during resuscitation, and pre-injury use of antithrombotic drugs. Although the pathophysiology of C-iTBI has not been fully elucidated, two distinct stages have been identified: an initial hypocoagulable phase that begins within the first 24 h, dominated by platelet dysfunction and hyperfibrinolysis, followed by a hypercoagulable state that generally starts 72 h after the trauma. The aim of this study was to design an acronym as a mnemonic device to provide clinicians with an auxiliary tool in the treatment of this complication.MethodsA narrative analysis was performed in which intensive care physicians were asked to list the key factors related to C-iTBI. The initial sample was comprised of 33 respondents. Respondents who were not physicians, not currently working in or with experience in coagulopathy were excluded. Interviews were conducted for a month until the sample was saturated. Each participant was asked a single question: Can you identify a factor associated with coagulopathy in patients with TBI? Factors identified by respondents were then submitted to a quality check based on published studies and proven evidence. Because all the factors identified had strong support in the literature, none was eliminated. An acronym was then developed to create the mnemonic device.Results and conclusionEleven factors were identified: cerebral computed tomography, oral anticoagulant & antiplatelet use, arterial blood pressure (Hypotension), goal-directed haemostatic therapy, use fluids cautiously, low calcium levels, anaemia-transfusion, temperature, international normalised ratio (INR), oral antithrombotic reversal, normal acid–base status, forming the acronym “Coagulation.” This acronym is a simple mnemonic device, easy to apply for anyone facing the challenge of treating patients of moderate or severe TBI on a daily basis. |
| first_indexed | 2024-03-09T02:37:39Z |
| format | Article |
| id | doaj.art-8dbdf960df624c6aaee4d46f3fe75098 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-09T02:37:39Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-8dbdf960df624c6aaee4d46f3fe750982023-12-06T08:13:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-12-011110.3389/fpubh.2023.13090941309094“COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unitManuel Quintana-Diaz0Manuel Quintana-Diaz1Manuel Quintana-Diaz2Pasquale Anania3Raúl Juárez-Vela4Raúl Juárez-Vela5Raúl Juárez-Vela6Emmanuel Echaniz-Serrano7Emmanuel Echaniz-Serrano8Clara Isabel Tejada-Garrido9Clara Isabel Tejada-Garrido10Pilar Sanchez-Conde11Kapil Nanwani-Nanwani12Kapil Nanwani-Nanwani13Ainhoa Serrano-Lázaro14Ainhoa Serrano-Lázaro15Pilar Marcos-Neira16María Gero-Escapa17Jorge García-Criado18Daniel Agustín Godoy19Department of Medicine, Faculty of Medicine, Autonomous University of Madrid, Madrid, SpainIntensive Care Unit, La Paz University Hospital, Madrid, SpainInstitute for Health Research (idiPAZ), La Paz University Hospital, Madrid, SpainDepartment of Neurosurgery, Ospedale Policlinico San Martino, Istituto di Ricovero eCura a Carattere Scientifico (IRCCS) for Oncology and Neuroscience, Genoa, ItalyInstitute for Health Research (idiPAZ), La Paz University Hospital, Madrid, SpainDepartment of Nursing, University of La Rioja, Logroño, SpainHealth and Healthcare Research Group (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, SpainDepartment of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, SpainAragon Healthcare Service, Aragon, Zaragoza, SpainDepartment of Nursing, University of La Rioja, Logroño, SpainHealth and Healthcare Research Group (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, SpainFaculty of Medicine, University of Salamanca, Salamanca, SpainIntensive Care Unit, La Paz University Hospital, Madrid, SpainInstitute for Health Research (idiPAZ), La Paz University Hospital, Madrid, SpainInstitute for Health Research (idiPAZ), La Paz University Hospital, Madrid, Spain0Intensive Care Unit, Valencia University Clinical Hospital, Valencia, Spain1Intensive Care Unit, Germans Trias i Pujol University Hospital, Badalona, Spain2Intensive Care Unit, Burgos University Hospital, Burgos, Spain3Emergency Department, University Hospital of Salamanca, Salamanca, Spain4Critical Care Department, Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, ArgentinaIntroductionCoagulopathy associated with isolated traumatic brain injury (C-iTBI) is a frequent complication associated with poor outcomes, primarily due to its role in the development or progression of haemorrhagic brain lesions. The independent risk factors for its onset are age, severity of traumatic brain injury (TBI), volume of fluids administered during resuscitation, and pre-injury use of antithrombotic drugs. Although the pathophysiology of C-iTBI has not been fully elucidated, two distinct stages have been identified: an initial hypocoagulable phase that begins within the first 24 h, dominated by platelet dysfunction and hyperfibrinolysis, followed by a hypercoagulable state that generally starts 72 h after the trauma. The aim of this study was to design an acronym as a mnemonic device to provide clinicians with an auxiliary tool in the treatment of this complication.MethodsA narrative analysis was performed in which intensive care physicians were asked to list the key factors related to C-iTBI. The initial sample was comprised of 33 respondents. Respondents who were not physicians, not currently working in or with experience in coagulopathy were excluded. Interviews were conducted for a month until the sample was saturated. Each participant was asked a single question: Can you identify a factor associated with coagulopathy in patients with TBI? Factors identified by respondents were then submitted to a quality check based on published studies and proven evidence. Because all the factors identified had strong support in the literature, none was eliminated. An acronym was then developed to create the mnemonic device.Results and conclusionEleven factors were identified: cerebral computed tomography, oral anticoagulant & antiplatelet use, arterial blood pressure (Hypotension), goal-directed haemostatic therapy, use fluids cautiously, low calcium levels, anaemia-transfusion, temperature, international normalised ratio (INR), oral antithrombotic reversal, normal acid–base status, forming the acronym “Coagulation.” This acronym is a simple mnemonic device, easy to apply for anyone facing the challenge of treating patients of moderate or severe TBI on a daily basis.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309094/fullcoagulopathydiagnosistraumatic brain injuryhaemostasisblood coagulationanticoagulants |
| spellingShingle | Manuel Quintana-Diaz Manuel Quintana-Diaz Manuel Quintana-Diaz Pasquale Anania Raúl Juárez-Vela Raúl Juárez-Vela Raúl Juárez-Vela Emmanuel Echaniz-Serrano Emmanuel Echaniz-Serrano Clara Isabel Tejada-Garrido Clara Isabel Tejada-Garrido Pilar Sanchez-Conde Kapil Nanwani-Nanwani Kapil Nanwani-Nanwani Ainhoa Serrano-Lázaro Ainhoa Serrano-Lázaro Pilar Marcos-Neira María Gero-Escapa Jorge García-Criado Daniel Agustín Godoy “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit Frontiers in Public Health coagulopathy diagnosis traumatic brain injury haemostasis blood coagulation anticoagulants |
| title | “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit |
| title_full | “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit |
| title_fullStr | “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit |
| title_full_unstemmed | “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit |
| title_short | “COAGULATION”: a mnemonic device for treating coagulation disorders following traumatic brain injury—a narrative-based method in the intensive care unit |
| title_sort | coagulation a mnemonic device for treating coagulation disorders following traumatic brain injury a narrative based method in the intensive care unit |
| topic | coagulopathy diagnosis traumatic brain injury haemostasis blood coagulation anticoagulants |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1309094/full |
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