Thromboelastography and Its Use in Pediatric Trauma Patients

Tanner, Thomas E.; Drapkin, Zachary; Fino, Nora; Russell, Katie W.; Chaulk, David; Hewes, Hilary A

doi:10.1097/pec.0000000000002642

Cited by 3 publications

(1 citation statement)

References 37 publications

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“…Abnormal quantity or function can lead to abnormal MA values, so MA values can better reflect the functional status of platelets than PLT. 33 α angle and K value are both indicators for detecting fibrinogen function, so changes in the count and function of fibrinogen and platelet can be analyzed in a timely manner based on the results. 34 The above results all suggested that TEG could help comprehensively evaluate the coagulation function status of sepsis patients, and could detect coagulation function abnormalities in patients earlier and more sensitively than conventional coagulation indicators.…”

Section: Discussionmentioning

confidence: 99%

The Value of Serum Procalcitonin, Thromboelastography Combined with Platelet Count in Predicting the Short-Term Progression of Septic Shock in the Intensive Care Unit

Zeng,

Yin,

et al. 2024

IJGM

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Objective By evaluating the level of serum procalcitonin (PCT), thromboelastography (TEG) and platelet count (PLT) of patients with septic shock in intensive care unit (ICU), the predictive value of the combination of the three indicators on the short-term progression was discussed, which provided a new basis for early clinical diagnosis and disease evaluation. Methods The clinical data of 130 patients with septic shock admitted to the IUC of our hospital from December 2021 to December 2023 were analyzed retrospectively. These subjects were divided into good prognosis group (n=78) and poor prognosis group (n=52) according to the 28 d deaths. The influencing factors were explored using the Multivariate logistic regression analysis. The value of single or combined PCT, PLT and TEG in predicting poor short-term prognosis was assessed using the receiver operating characteristic (ROC) curve. Results The patients in poor prognosis group had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, serum PCT level, coagulation reaction time (R value) and coagulation formation time (K value), but lower PLT levels, final strength of coagulation (MA value) and coagulation formation rate (α angle) than those in good prognosis group ( P <0.001). PCT, R value and K value were risk factors ( P <0.001), while PLT, MA value and α angle were protective factors ( P <0.001). The area under the curve (AUC) of PCT, PLT and TEG predicting poor short-term progression was 0.813, 0.658 and 0.752, respectively. The AUC of combined three indicators was 0.905, which had the highest predictive value. Conclusion Serum levels of PCT, PLT and TEG had certain value in predicting poor short-term progression of septic shock patients, and their combined diagnostic value was higher. Therefore, regular monitoring of these three indicators could provide certain guiding significance for the prevention and treatment of poor short-term prognosis in patients with septic shock.

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Section: Discussionmentioning

confidence: 99%

The Value of Serum Procalcitonin, Thromboelastography Combined with Platelet Count in Predicting the Short-Term Progression of Septic Shock in the Intensive Care Unit

Zeng,

Yin,

et al. 2024

IJGM

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What, When, and Why: Viscoelastic Hemostatic Assays and Their Uses in Trauma Resuscitation

Burkhart,

Smith,

Hill

et al. 2024

The American Surgeon™

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Viscoelastic hemostatic assays (VHAs) have become a valuable tool in guiding transfusion therapy, particularly in trauma care. While various forms of VHA exist, all provide a quantitative assessment of clot kinetics, strength, and dissolution. Studies have demonstrated that VHA can reduce both mortality and utilization of blood products in the general population. Interpreting VHA results requires consideration of specific patient factors, such as age and altered physiological properties as in pregnancy and the process of aging. Further research is needed to establish accurate reference ranges for these specific populations. This review article provides a comprehensive overview of the technical aspects of VHA as well as their clinical uses in trauma resuscitation.

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Base Deficit, International Normalized Ratio, and Glasgow Coma Scale (BIG) is a Predictor Tool for Survival and Mortality of Pediatric Trauma Patients

Raffee,

Al-Mistarehi,

Alawneh

et al. 2024

Cureus

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Background: An accurate estimate of the survival and mortality at the initial trauma evaluation is essential to ensure appropriate triage and stratification of the patients for progressive care. One of the recognized tools for predicting mortality is the BIG Score, composed of admission base deficit, international normalized ratio (INR), and Glasgow Coma Scale (GCS). This study evaluates the BIG scale in predicting survival and mortality rates among pediatric trauma patients. Methods: Pediatric trauma patients, aged <18 years, visiting the emergency department of a tertiary hospital in the North of Jordan from 2014 to 2019 were included. Demographic data, trauma details, and lab results were collected. The BIG score for each patient was calculated. A receiver operator characteristic (ROC) curve was generated to determine the best suitable BIG cutoff point and its probabilities. Results: A total of 424 patients were included in this study. About two-thirds of the patients were males (n=298). The mean±SD of pH and GCS values were significantly lower among dead patients (6.0±2.5, 3.7±3.9, respectively) in comparison to alive ones (7.3±2.7, 11.5±5.5, respectively) ( p =0.026, p <0.001, respectively). On the other hand, base deficit and INR values were significantly higher among dead patients (6.5±6.2, 1.9±2.5, respectively) than alive ones (1.9±3.6, 0.8±0.5, respectively), ( p <0.001). The BIG score with a cutoff point of ≥10.0 has a high sensitivity (88.5%) and specificity (76.3%) for mortality prediction. The survival rate was correctly predicted in 100% of patients with a BIG score between 2.1 and 6. Also, the best survival predictions were seen in intubated patients (100%), followed by RTA-related trauma and ICU admission with decreasing frequency. Conclusions: The current study has shown the added value of the BIG score as a simple and rapid tool to predict prognosis in pediatric trauma settings. The BIG score with a cutoff point of ≥10.0 is highly efficient in predicting pediatric trauma patients' mortality rates. However, the BIG score demonstrates greater accuracy in predicting survival outcomes compared to its ability to predict mortality among pediatric trauma patients.

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Thromboelastography and Its Use in Pediatric Trauma Patients

Cited by 3 publications

References 37 publications

The Value of Serum Procalcitonin, Thromboelastography Combined with Platelet Count in Predicting the Short-Term Progression of Septic Shock in the Intensive Care Unit

The Value of Serum Procalcitonin, Thromboelastography Combined with Platelet Count in Predicting the Short-Term Progression of Septic Shock in the Intensive Care Unit

What, When, and Why: Viscoelastic Hemostatic Assays and Their Uses in Trauma Resuscitation

Base Deficit, International Normalized Ratio, and Glasgow Coma Scale (BIG) is a Predictor Tool for Survival and Mortality of Pediatric Trauma Patients

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