Rapid Thrombelastography Delivers Real-Time Results That Predict Transfusion Within 1 Hour of Admission

Cotton, Bryan A.; Faz, Gabriel; Hatch, Quinton; Radwan, Zayde A.; Podbielski, Jeanette; Wade, Charles E.; Kozar, Rosemary A.; Holcomb, John B.

doi:10.1097/ta.0b013e31821e1bf0

Cited by 212 publications

(205 citation statements)

References 23 publications

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“…Rapid hemostasis testing may be carried out in the clinical laboratory [3,4], in a satellite laboratory [5], or as point-of-care testing in the operating room or trauma suite [6][7][8][9][10][11].…”

Section: Clinical Situationmentioning

confidence: 99%

“…The sensitivity of these systems is limited, although viscoelastic clotting times have shown a poor correlation with measured factor levels during cardiopulmonary bypass [15], but a modest correlation with PT and PTT during trauma [5]. The rate of clot formation (angle) and maximum clot formation (amplitude) is related to coagulation factor levels, fibrinogen concentration, and platelet count in the sample [3,5,15]. Whole-blood clotting times are not specific for any one factor and are affected by changes in any of the coagulation factors to varying degrees.…”

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

“…Clinical situations where viscoelastic assays have been used to evaluate hemostasis include trauma resuscitation, during and after cardiopulmonary bypass, and liver transplantation [5,7,10,18]. Typically, clotting times are used to estimate need for fresh-frozen plasma or factor concentrates, amplitude is used to estimate need for platelet transfusion, and whole-blood fibrinogen assays for cryoprecipitate or fibrinogen concentrate [7].…”

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

“…Viscoelastic testing may also be performed in a satellite laboratory associated with the patient care area [5] or as point-of-care testing in the operating room or trauma suite [7,8,10].…”

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

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Emergency assessment of hemostasis in the bleeding patient

Chandler

2013

Int J Lab Hematology

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Summary Emergency hemostasis testing is typically used to determine which blood products are needed to correct hemostatic defects associated with bleeding. Rapid assessment of hemostasis can be performed using standard or viscoelastic hemostasis tests in the clinical laboratory, satellite laboratory, or using point‐of‐care methods. The major drawback of standard coagulation testing is that most clinical laboratories are focused more on accuracy than on turnaround time. Improving turnaround times may require revision of the entire approach to performing the testing in the clinical laboratory including specimen processing, testing, and reporting. An advantage to rapid central laboratory testing is the availability to all areas of the hospital, not just the emergency department or operating rooms. Use of point‐of‐care assays can improve turnaround times, but point‐of‐care tests typically show more variation and lower precision. Viscoelastic global hemostasis tests can be used for rapid assessment as well, but care needs to be taken in the interpretation of the results. Viscoelastic testing is currently the only method that can detect severe fibrinolysis. Platelet function testing is useful for detection of hereditary platelet function problems and some antiplatelet medication monitoring, but is less useful for preoperative bleeding risk assessment or diagnosing the cause of acquire bleeding syndromes. This review will highlight different approaches to the rapid assessment of hemostasis.

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Section: Clinical Situationmentioning

confidence: 99%

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

“…Viscoelastic testing may also be performed in a satellite laboratory associated with the patient care area [5] or as point-of-care testing in the operating room or trauma suite [7,8,10].…”

Section: Viscoelastic Global Hemostasis Ass Aysmentioning

confidence: 99%

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Emergency assessment of hemostasis in the bleeding patient

Chandler

2013

Int J Lab Hematology

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show abstract

“…However, CCTs illustrate the coagulation process in a static state, and the acceptable levels for CCTs in TBI are largely center dependent and have not been validated for use in the characterization of coagulopathy during active hemorrhage [13,14]. Additionally, long turn-around times make CCTs less than ideal for trauma and TBI patients [15,16].…”

Section: Introductionmentioning

confidence: 99%