The intersection of coagulation activation and inflammation after injury: What you need to know

Coagulopathy and acute organ dysfunction are indicative of the systemic inflammatory response syndrome (SIRS) that is frequently seen in severely injured patients. While we often note these clinical signs in patients during the early postinjury management, these events do not occur in isolation. In fact, the coagulation system, immune system, and complement system all interact and precipitate coagulopathy, platelet dysfunction, cytokine release, immune cell activation, and endotheliopathy that must be resolved to ensure adequate resuscitation and recovery from injury (Fig. 1). Knowledge of the extensive crosstalk that occurs between these systems is essential to understanding the physiology of severely injured patients and to optimize the return to homeostasis through resuscitation and correction of coagulopathy. Promptly correcting coagulopathy and resolving SIRS is essential to mitigate organ dysfunction and multiorgan failure that can cause significant morbidity postinjury.