Thromboelastometry fails to detect auto-heparinization after major trauma and hemorrhagic shock.

BACKGROUND Heparan sulfate is an integral component of the glycocalyx that provides an anticoagulant layer close to the endothelium. Hypoperfusion, inflammation and sympathoadrenal activation following major trauma result in glycocalyx shedding and subsequent release of heparan sulfate into the bloodstream. The possible anticoagulant effect of this auto-heparinization has been suggested as a potential driver of trauma-induced coagulopathy. We...