Thromboelastography Predictive of Death in Trauma Patients

Kane, Ian W.; Ong, Alvin; Orozco, Fabio; Post, Zachary D.; Austin, Luke; Radcliff, Kris E.

doi:10.1111/os.12158

Cited by 29 publications

(22 citation statements)

References 28 publications

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“…In addition, TEG/ROTEM could provide additional prognostic information in trauma. A low α‐angle value predicted massive transfusion (Jeger et al , ), and the hypocoagulant and/or hyperfibrinolytic states were shown to predict a higher mortality (Theusinger et al , ; Kane et al , ). The potential for TEG/ROTEM rather than sensitive tests such as plasmin‐antiplasmin complexes to quickly and accurately detect the early stage of hyperfibrinolysis is controversial, however (Larsen et al , ; Raza et al , ).…”

Section: Acquired Bleeding Disordersmentioning

confidence: 99%

The utility of thromboelastography in inherited and acquired bleeding disorders

Nogami

2016

Br J Haematol

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Thromboelastography (TEG) was first described by Hartert in 1948, and was designed to monitor viscoelastic clot strength in whole blood in real time. The current TEG method and Rotational Thromboelastometry (ROTEM) were subsequently developed from the original principles. Both of the modern methods provide data by measuring changes in the viscoelastic strength of a small sample of clotting blood in response to a constant rotational force. The important advantage of these techniques is to visually observe and quantify blood coagulation including the propagation, stabilization and dissolution phases of clot formation under low shear conditions. Analysis of the results provides detailed kinetic data on fibrin generation, clot strength and fibrinolysis. These TEG/ROTEM analyses therefore enable evaluation of global clotting function and the monitoring of haemostatic treatment in various clinical situations, not only in patients with genetic bleeding disorders, such as haemophilia, but also in patients undergoing cardiac surgery, liver transplantation or suffering from traumatic injury. Some evidence suggests that haemostatic management using TEG/ROTEM leads to a reduction in total transfusions of whole blood or clotting factors. Wider clinical application of this technology seems likely.

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Section: Acquired Bleeding Disordersmentioning

confidence: 99%

The utility of thromboelastography in inherited and acquired bleeding disorders

Nogami

2016

Br J Haematol

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“…TEG has been shown to be effective in monitoring the coagulability of patients on antiplatelet and anticoagulants and in patients with clinical coagulapathies . Furthermore, TEG has been shown to decrease blood component transfusion in pediatric cardiac surgical patients and can aid in the prediction of mortality in trauma patients . Limited data exist describing the use of TEG in sheep.…”

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confidence: 99%

Assessment of Thrombelastography and Platelet Life Span in Ovines

et al. 2018

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Ovines are a common animal model for the study of cardiovascular devices, where consideration of blood biocompatibility is an essential design criterion. In the ovine model, tools to assess blood biocompatibility are limited and continued investigation to identify and apply additional assays is merited. Toward this end, the thrombelastograph, clinically utilized to assess hemostasis, was employed to characterize normal ovine parameters. In addition, platelet labeling with biotin was evaluated for its potential applicability to quantify ovine platelet life span. Mean ovine thrombelastograph values were reaction-time: 4.9 min, K-time: 2 min, angle: 64.1°, maximum amplitude: 68.6 mm, actual clot strength: 11.9 Kd/sc, and coagulation index: 1.5. Reaction time was significantly shorter and maximum amplitude, actual clot strength, and coagulation index were all significantly higher when compared to normal human thrombelastograph values suggesting some hypercoagulability of sheep blood. Biotinylation and reinfusion of ovine platelets allowed temporal tracking of the labeled platelet cohort with flow cytometry. These data indicated a mean ovine platelet life span of 188 h with a half-life of 84 h. The collection of these parameters for normal ovines demonstrates the applicability of these techniques for subsequent studies where cardiovascular devices may be evaluated, and provides an indication of normal ovine values for comparison purposes.

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“…The fractures are completely unstable; thus, 3 dimensional displacement and deformities are frequent. TSD always has associated injuries and the Injury Severity Scores (ISS) are high. Damage Control Orthopaedics (DCO) protocol should be undertaken through the whole treatment period if the injury is severe (ISS >17).…”

Section: Discussionmentioning

confidence: 99%