The velocity curve of the clotting waveform of rotational thromboelastometry predicts bleeding after cardiac surgery but conventional rotational thromboelastometric parameters do not

Nam, Karam; Jeon, Yunseok; Kim, Tae Kyoung; Jo, Woo Young; Yoon, Se-Hee; Kwak, Jooah; Cho, Youn J.

doi:10.23736/s0375-9393.18.12960-9

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…The AUC has not been studied in such scenarios, but a decreased AUC correlated with an increased risk of (re)bleeding during surgery. [37][38][39] Other viscoelastic clot formation parameters, such as CFT, have shown significantly more inconstant values in other studies, so the AUC parameter we used may be a more robust parameter to represent the velocity of clot formation. 11,13 It must be emphasized that there is no established standardized in-vitro approach to measure the influence of dressings on coagulation.…”

Section: Discussionmentioning

confidence: 99%

“…It seems that this effect can be counteracted by hemostatic agents. The AUC has not been studied in such scenarios, but a decreased AUC correlated with an increased risk of (re)bleeding during surgery 37–39 . Other viscoelastic clot formation parameters, such as CFT, have shown significantly more inconstant values in other studies, so the AUC parameter we used may be a more robust parameter to represent the velocity of clot formation 11,13 .…”

Section: Discussionmentioning

confidence: 99%

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Hemostatics in patients with inhibited coagulation—A viscoelastic in‐vitro analysis

et al. 2023

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Background The military has used topical hemostatic agents to successfully treat life‐threatening external bleeding for years. In contrast to the military environment, the general population are increasingly prescribed anticoagulants. There are only few comparative evaluations of topical hemostatic agents with anticoagulated human blood. It is important to understand the impact of these agents on those who take anticoagulants. Study design and Methods Citrated blood of patients treated with enoxaparin, heparin, and acetylsalicylic acid, apixaban or phenprocoumon was incubated with different hemostatic agents (QuikClot Gauze, Celox Granules, Celox Gauze, Chito SAM 100, WoundClot Trauma Gauze, QuikClot Gauze Moulage Trainer and Kerlix) and rotational thromboelastometry was performed with non‐activated thromboelastometry (NATEM reagent). Results All tested agents improved the onset of coagulation in all anticoagulants, mostly to a significant degree. Most significant improvements were produced by QuikClot Gauze and QuikClot Gauze Moulage Trainer, followed by the tested chitosans (Celox Granules, Celox Gauze, Chito SAM 100). Of the anticoagulant groups, the most significant improvements were seen in enoxaparin. This was followed in order by apixaban, heparin, and acetylsalicylic acid, and phenprocoumon. Discussion All the hemostatic agents tested were able to activate the clotting cascade earlier and initiate faster clot formation in anticoagulated blood. A definitive head‐to‐head comparison is not feasible, because of the limitations of an in‐vitro analysis. However, the sometimes‐presented hypothesis that kaolin‐based hemostatic agents are ineffective in anticoagulated blood is inaccurate according to our data. Hemostasis with hemostatic agents appears most challenging with phenprocoumon.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemostatics in patients with inhibited coagulation—A viscoelastic in‐vitro analysis

et al. 2023

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“…Nam et al conducted a retrospective analysis of 534 cardiac surgery patients studied with rotational thromboelastography (roteM) and reported that the first derivative curve (V-curve) could predict the risk of perioperative bleeding better than the parameters traditionally used. 104 doses. an algorithm of perioperative management and treatment of complications was also presented.…”

Section: Perioperative Medicinementioning

confidence: 99%

A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine

Cavaliere

Allegri²,

Apan

et al. 2020

Minerva Anestesiol

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“…However, these studies have had a relatively low number of patients and have not included an examination of the derived velocity curves, which are generated in the TEG software. These velocity markers have been suggested to be surrogate biomarkers of thrombin generation, which in humans have been investigated as predictors of postsurgical bleeding (Adamantos et al ., 2015; Nam et al ., 2019; Sigrist et al ., 2021; Zoia & Caldin, 2015).…”

Section: Introductionmentioning

confidence: 99%

Clinical bleeding diathesis, laboratory haemostatic aberrations and survival in dogs infected with Angiostrongylus vasorum: 180 cases (2005‐2019)

Thomsen,

Petersen,

Willesen

et al. 2024

J of Small Animal Practice

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ObjectivesBleeding diathesis is a complication in dogs infected with Angiostrongylus vasorum. This retrospective study investigated clinical and laboratory haemostatic differences in A. vasorum‐positive dogs with and without signs of bleeding and impact of bleeding on survival.Materials and MethodsDemographics, type of clinical bleeding, haematocrit and a range of haemostatic tests, including thromboelastography and derived velocity curves were retrospectively registered from A. vasorum‐positive dogs. All parameters were compared between dogs with and without signs of bleeding using univariable analyses. Binomial and multinomial regression models were applied to examine specific indicators in the bleeding dogs. P‐values were false discovery rate adjusted, and adjusted P<0.05 was considered significant.ResultsOne hundred and eighty dogs entered the study, including 65 dogs (36.1%) presenting with bleeding diathesis. Different types of cutaneous and mucosal bleeding were the most common clinical findings. Twenty dogs presented with neurological signs associated with intracranial and intra‐spinal bleeding. One hundred and thirty‐seven dogs had haematological and/or haemostatic laboratory analyses performed. Haematocrit, platelet count, thromboelastographic angle, maximum amplitude, global clot strength, maximum rate of thrombin generation and total thrombin generation were decreased, while prothrombin time was prolonged in bleeding dogs. Survival rate of bleeding dogs was lower at hospital discharge (76.9%) and 1 month after diagnosis (66.0%) than in dogs without signs of bleeding (94.8% and 90.1% at discharge and at 1 month, respectively).Clinical SignificanceSeveral haemostatic aberrations were detected in A. vasorum‐positive dogs with bleeding diathesis. Bleeding was identified as an important negative prognostic indicator in A. vasorum‐positive dogs.

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The velocity curve of the clotting waveform of rotational thromboelastometry predicts bleeding after cardiac surgery but conventional rotational thromboelastometric parameters do not

Cited by 5 publications

References 35 publications

Hemostatics in patients with inhibited coagulation—A viscoelastic in‐vitro analysis

Hemostatics in patients with inhibited coagulation—A viscoelastic in‐vitro analysis

A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine

Clinical bleeding diathesis, laboratory haemostatic aberrations and survival in dogs infected with Angiostrongylus vasorum: 180 cases (2005‐2019)

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