Application of a TEG-Platelet Mapping Algorithm to Guide Reversal of Antiplatelet Agents in Adults with Mild-to-Moderate Traumatic Brain Injury: An Observational Pilot Study

Kvint, Svetlana; Gutierrez, Alexis; Venezia, Anya; Maloney, Eileen; Schuster, James M.; Kumar, Monisha A.

doi:10.1007/s12028-022-01535-x

Cited by 5 publications

(5 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ein Mangel an Von-Willebrand-Faktor (vWF) oder Faktor XIII (FXIII) kann mithilfe von VET nicht oder nur unzureichend detektiert werden. Plättchendysfunktionen werden mithilfe von VET ebenfalls nur ungenügend erfasst, nur das für die TEG entwickelte Platelet-Mapping™ (PM) ermöglicht die grobe Abschätzung einer möglichen Plättchenfunktionsstörung [ 46 ]. Auch DOAC können mit den üblicherweise verwendeten Standard-Assays nur mit unzureichender Sensitivität und Spezifität detektiert werden [ 47 , 48 ], dafür sind DOAC-spezifische Reagenzien notwendig [ 29 ].…”

Section: Einschränkung Der Vet-methodenunclassified

See 1 more Smart Citation

Update on point-of-care-based coagulation treatment

Schmitt,

Schöchl,

Brün

et al. 2024

Anaesthesiologie

View full text Add to dashboard Cite

ZusammenfassungPoint-of-care(POC)-taugliche viskoelastische Testverfahren (VET) sind im klinischen Einsatz weitverbreitet. Aufgrund des erweiterten Spektrums an verfügbaren Geräten und insbesondere durch die Entwicklung neuer Testansätze bzw. -methoden ist aus Sicht der Autoren ein Update der aktuellen Behandlungsalgorithmen notwendig. Ziel dieses Artikels ist es, einen Überblick sowohl über die aktuell verfügbaren VET-Geräte als auch über die dazugehörigen Reagenzien zu vermitteln. Darüber hinaus werden 2 Therapiealgorithmen für die am häufigsten im deutschsprachigen Raum eingesetzten VET-Geräte vorgestellt.

show abstract

Section: Einschränkung Der Vet-methodenunclassified

“…Der Stellenwert der Plättchenfunktionstestung, als Ergänzung des diagnostischen Spektrums, im Rahmen schwerer Blutungen konnte bislang nicht eindeutig belegt werden [ 26 , 30 , 46 ]. Sowohl die technologische Umsetzung als auch die verfügbaren Reagenzien unterscheiden sich z. T. erheblich voneinander [ 50 , 51 ].…”

Section: Plättchenfunktionstestungunclassified

Update on point-of-care-based coagulation treatment

Schmitt,

Schöchl,

Brün

et al. 2024

Anaesthesiologie

View full text Add to dashboard Cite

show abstract

“…Despite this fact, the impact of platelet function testing as an additive and helpful diagnostic tool for detection of platelet dysfunction has not been conclusively demonstrated so far. Moreover, the predictive value of POC platelet function testing for perioperative bleeding and potential transfusion requirements is poor [15,16,[99][100][101]. To date, therapy algorithms based on platelet function testing have not produced convincing results [100,101].…”

Section: The Value Of Platelet Function Testing In Traumamentioning

confidence: 99%

Point-of-care, goal-directed management of bleeding in trauma patients

Zipperle,

Schmitt,

Schöchl

2023

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of the review The purpose of this review is to consider the clinical value of point-of-care (POC) testing in coagulopathic trauma patients with traumatic brain injury (TBI) and trauma-induced coagulopathy (TIC). Recent findings Patients suffering from severe TBI or TIC are at risk of developing pronounced haemostatic disorders. Standard coagulation tests (SCTs) are insufficient to reflect the complexity of these coagulopathies. Recent evidence has shown that viscoelastic tests (VETs) identify haemostatic disorders more rapidly and in more detail than SCTs. Moreover, VET results can guide coagulation therapy, allowing individualised treatment, which decreases transfusion requirements. However, the impact of VET on mortality remains uncertain. In contrast to VETs, the clinical impact of POC platelet function testing is still unproven. Summary POC SCTs are not able to characterise the complexity of trauma-associated coagulopathy. VETs provide a rapid estimation of underlying haemostatic disorders, thereby providing guidance for haemostatic therapy, which impacts allogenic blood transfusion requirements. The value of POC platelet function testing to identify platelet dysfunction and guide platelet transfusion is still uncertain.

show abstract

“…TEG‐PM™ is a type of TEG that also has platelet mapping aimed to describe platelet aggregometry. A retrospective study by Kvint and colleagues found the use of a TEG‐PM™ guided algorithm for TBI patients decreased platelet transfusions without compromising hematoma expansion 58 . Another retrospective study of 57 TBI patients on antiplatelet agents used TEG‐PM™ results to guide use of desmopressin and platelet transfusions.…”

Section: Medication‐induced Coagulopathymentioning

confidence: 99%

“…A retrospective study by Kvint and colleagues found the use of a TEG-PM™ guided algorithm for TBI patients decreased platelet transfusions without compromising hematoma expansion. 58 Another retrospective study of 57 TBI patients on antiplatelet agents used TEG-PM™ results to guide use of desmopressin and platelet transfusions. There was no difference on follow-up PM values between patients who received desmopressin or platelets.…”

Section: Medication-induced Coagulopathymentioning

confidence: 99%

The clot thickens: How to use viscoelastic testing in critical illness

Rech

Gilbert

Nei

et al. 2023

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Coagulopathy is common in critically ill patients and may result in complications such as bleeding or thromboembolic events. Viscoelastic testing (VET), including both thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®), offers a benefit over conventional coagulation tests in that it provides a qualitative and quantitative assessment of the degree of coagulopathy, including the ability to measure fibrinolysis. This review is a “how‐to” primer for critical care pharmacists to interpret and utilize VET in practice across a spectrum of coagulopathies, including trauma and traumatic brain injury, neurologic injury and emergencies, cardiothoracic surgery, liver disease, and medication‐induced coagulopathy.

show abstract

Application of a TEG-Platelet Mapping Algorithm to Guide Reversal of Antiplatelet Agents in Adults with Mild-to-Moderate Traumatic Brain Injury: An Observational Pilot Study

Cited by 5 publications

References 102 publications

Update on point-of-care-based coagulation treatment

Update on point-of-care-based coagulation treatment

Point-of-care, goal-directed management of bleeding in trauma patients

The clot thickens: How to use viscoelastic testing in critical illness

Contact Info

Product

Resources

About