Review of Thromboelastography in Neurocritical Care

Kreitzer, Natalie; Bonomo, Jordan; Kanter, Daniel; Zammit, Christopher

doi:10.1007/s12028-015-0187-9

Cited by 12 publications

(9 citation statements)

References 33 publications

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“…8 The advantages of thromboelastography over traditional coagulation parameters include provision of reliable evidence to diagnose disease related to coagulation defects, as well as real-time assessment to assist in the management of component-based transfusions. 9 Thromboelastography has been used to assess hypercoagulable states and coagulation defects during pregnancy. 10,11 The whole-blood thromboelastography profiles of women with pre-eclampsia have also been investigated.…”

Section: Introductionmentioning

confidence: 99%

“…The coagulation index provides an overall assessment of coagulability and is calculated using a mathematical formula that considers the relative contribution of time r , time k , α angle, and maximum amplitude in a single equation . The advantages of thromboelastography over traditional coagulation parameters include provision of reliable evidence to diagnose disease related to coagulation defects, as well as real‐time assessment to assist in the management of component‐based transfusions . Thromboelastography has been used to assess hypercoagulable states and coagulation defects during pregnancy .…”

Section: Introductionmentioning

confidence: 99%

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The ability of thromboelastography parameters to predict severe pre‐eclampsia when measured during early pregnancy

Wang

Cheng

et al. 2019

Intl J Gynecology & Obste

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Objective To examine the predictive value of thromboelastography parameters during early pregnancy as potential markers of severe pre‐eclampsia during late pregnancy. Methods An observational retrospective case–control study was conducted among pregnant women who attended a single hospital in Shanghai, China, between July 1, 2016, and February 31, 2018. Data were obtained from medical records and a structured questionnaire completed by the participants. Thromboelastography parameters included time r; time k; α angle; maximum amplitude; clot lysis at 60 minutes; and coagulation index. Other risk factors for severe pre‐eclampsia were also assessed. Results The pre‐eclampsia and control groups comprised 46 and 138 women, respectively. Women with a coagulation index below zero at 13–20 weeks experienced an increased risk of severe pre‐eclampsia (odds ratio [OR] 31.72, 95% confidence interval [CI] 11.28–89.24; P<0.001). Other risk factors for severe pre‐eclampsia were family history of hypertension (OR 3.79, 95% CI 1.21–11.48; P=0.017) and pre‐pregnancy body mass index (OR 2.83, 95% CI 1.14–7.36; P=0.023). Conclusion Coagulation index determined by thromboelastography was an early marker for severe pre‐eclampsia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The ability of thromboelastography parameters to predict severe pre‐eclampsia when measured during early pregnancy

Wang

Cheng

et al. 2019

Intl J Gynecology & Obste

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“…Serial analysis of TEG parameters would have better elucidated the dynamics of hemostatic abnormalities in these patients Factors such as blood sample collection technique, transportation time of sample from the Intensive Care Unit (ICU) to laboratory and the TEG assay used (e.g., kaolin or heparinase TEG) are also crucial for an accurate interpretation of the coagulation pattern by TEG. [ 2 3 ] This information needs to be clearly mentioned in the methodology TEG per se is not a good method for assessment of platelet function, for which better modalities are available. [ 4 5 ] It is difficult to correlate platelet count with platelet function using TEG Some patients with dengue might have been in sepsis as well, which can further influence the coagulation profile The references cutoff values for TEG have been provided by manufacturer (from studies on western population), which may not be applicable to our setup.…”

mentioning

confidence: 99%

“…Factors such as blood sample collection technique, transportation time of sample from the Intensive Care Unit (ICU) to laboratory and the TEG assay used (e.g., kaolin or heparinase TEG) are also crucial for an accurate interpretation of the coagulation pattern by TEG. [ 2 3 ] This information needs to be clearly mentioned in the methodology…”

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confidence: 99%

Thromboelastographic analysis of hemostatic abnormalities in dengue patients admitted in a multidisciplinary intensive care unit: A cross-sectional study

Muzaffar

Siddiqui

Azim

2018

Indian Journal of Critical Care Medicine

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“…ROTEM and TEG are both device dependent; serial studies from the same patient should be run on the same machine. 25 An oft-cited limitation of VHAs concerns a perceived lack of validation. Robust correlations between VHAs and CCTs have been reported, such as between FIBTEM MCF and plasma fibrinogen level 16 and between TEG MA and platelet count.…”

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confidence: 99%

Neurosurgical applications of viscoelastic hemostatic assays

Kvint¹,

Schuster²,

Kumar

2017

Neurosurgical Focus

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Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient’s exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years. Furthermore, thromboembolic complications such as deep venous thrombosis, pulmonary embolism, and myocardial infarction are common complications of major surgery. These trends, in conjunction with a growing understanding of the hemostatic process and its contribution to the pathophysiology of disease, stress the importance of the complete evaluation of a patient’s hemostatic profile in guiding management decisions. Viscoelastic hemostatic assays (VHAs), such as thromboelastography and rotational thromboelastometry, are global assessments of coagulation that account for the cellular and plasma components of coagulation. This FDA-approved technology has been available for decades and has been widely used in cardiac surgery and liver transplantation. Although VHAs were cumbersome in the past, advances in software and design have made them more accurate, reliable, and accessible to the neurosurgeon. VHAs have demonstrated utility in guiding intraoperative blood product transfusion, identifying coagulopathy in trauma, and managing postoperative thromboprophylaxis. The first half of this review aims to evaluate and assess VHAs, while the latter half seeks to appraise the evidence supporting their use in neurosurgical populations.

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Review of Thromboelastography in Neurocritical Care

Cited by 12 publications

References 33 publications

The ability of thromboelastography parameters to predict severe pre‐eclampsia when measured during early pregnancy

The ability of thromboelastography parameters to predict severe pre‐eclampsia when measured during early pregnancy

Thromboelastographic analysis of hemostatic abnormalities in dengue patients admitted in a multidisciplinary intensive care unit: A cross-sectional study

Neurosurgical applications of viscoelastic hemostatic assays

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