Rotational thromboelastometry and standard coagulation tests for live liver donors

2013 ◽  
Vol 27 (2) ◽  
pp. E101-E108 ◽  
Author(s):  
Maged Mohammed ◽  
Nirmeen Fayed ◽  
Ashraf Hassanen ◽  
Fatma Ahmed ◽  
Wessam Mourad ◽  
...  
Keyword(s):  
Rotational Thromboelastometry ◽  
Coagulation Tests ◽  
Liver Donors

scholarly journals Rotational thromboelastometry results are associated with care level in COVID-19

2020 ◽  
Author(s):  
Lou M. Almskog ◽  
Agneta Wikman ◽  
Jonas Svensson ◽  
Michael Wanecek ◽  
Matteo Bottai ◽  
...  
Keyword(s):  
Disease Severity ◽  
Blood Type ◽  
Care Level ◽  
Rotational Thromboelastometry ◽  
Moderate Disease ◽  
High Prevalence ◽  
Coagulation Tests ◽  
Ventilation Support ◽  
Level 1 ◽  
Maximum Clot Firmness

Abstract High prevalence of thrombotic events in severely ill COVID-19 patients have been reported. Pulmonary embolism as well as microembolization of vital organs may in these individuals be direct causes of death. The identification of patients at high risk of developing thrombosis may lead to targeted, more effective prophylactic treatment. The primary aim of this study was to test whether rotational thromboelastometry (ROTEM) at admission indicates hypercoagulopathy and predicts the disease severity, assessed as care level, in COVID-19 patients. The study was designed as a prospective, observational study where COVID-19 patients over 18 years admitted to hospital were eligible for inclusion. Patients were divided into two groups depending on care level: (1) regular wards or (2) wards with specialized ventilation support. Conventional coagulation tests, blood type and ROTEM were taken at admission. 60 patients were included; age 61 (median), 67% men, many with comorbidities (e.g. hypertension, diabetes). The ROTEM variables Maximum Clot Firmness (EXTEM-/FIBTEM-MCF) were higher in COVID-19 patients compared with in healthy controls (p < 0.001) and higher in severely ill patients compared with in patients at regular wards (p < 0.05). Our results suggest that hypercoagulopathy is present early in patients with mild to moderate disease, and more pronounced in severe COVID-19 pneumonia. Non-O blood types were not overrepresented in COVID-19 positive patients. ROTEM variables showed hypercoagulopathy at admission and this pattern was more pronounced in patients with increased disease severity. If this feature is to be used to predict the risk of thromboembolic complications further studies are warranted.

Reference ranges of rotational thromboelastometry parameters in pregnant women and puerperas: a single-center randomized trial

2020 ◽  
Author(s):  
Ю.С. Распопин ◽  
В.В. Потылицина ◽  
А.И. Грицан ◽  
А.В. Ковалев ◽  
И.А. Ольховский
Keyword(s):  
Pregnant Women ◽  
Postpartum Period ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Rotational Thromboelastometry ◽  
Early Postpartum Period ◽  
Krasnoyarsk Region ◽  
Early Postpartum ◽  
Coagulation Tests ◽  
Obstetric Surgery

Введение: В последнее время стали востребованы интегральные тесты оценки системы гемостаза у женщин во время беременности, а также во время акушерских операций, связанных с кровотечением. В нашей стране отсутствуют работы по определению популяционных норм ротационной тромбоэластометрии (РОТЕМ) у беременных, рожениц и родильниц. Цель исследования: определить пределы референсных интервалов показателей РОТЕМ во время физиологически протекающей беременности и в раннем послеродовом периоде и провести корреляционный анализ со стандартными показателями коагулограммы. Материалы и методы: Обследовано 229 женщин Красноярского края, которые были поделены на 5 групп: небеременные (контроль), беременные II и III триместров, женщины раннего послеродового периода после операции кесарева сечения и естественных родов. Все женщины были сопоставимы по возрасту, индексу массы тела, сопутствующей патологии. Референсные интервалы рассчитывали либо через среднее и стандартное отклонение (для нормального распределения), либо через медиану и 2,5 и 97,5% перцентили (для ненормального распределения). Результаты: В процессе исследования подтвердилось, что во время беременности и в раннем послеродовом периоде происходят изменения в системе гемостаза в сторону гиперкоагуляции. Показатели ROTЕM у женщин в III триместре беременности и раннем послеродовом периоде существенно отличаются от показателей небеременных в популяции. У женщин после родов вне зависимости от способа родоразрешения различий между параметрами ROTЕM не установлено. Корреляция между параметрами ROTЕM и традиционными лабораторными тестами коагуляции выявила взаимосвязь между амплитудой плотности сгустка в тесте FIBTEM и уровнем фибриногена по Клаусу. Заключение: Представлены референсные интервалы параметров РОТЕМ у женщин Красноярского края. Найдена корреляция между параметрами РОТЭМ и уровнем фибриногена. Background: Recently, integral tests for hemostasis assessment in pregnant women as well as during obstetric surgery associated with bleeding have become popular. In our country, there are no studies of population norms for rotational thromboelastometry (ROTEM) in pregnant women, parturients and puerperants. Objectives: to identify reference intervals limits for ROTEM parameters during physiological pregnancy and in early postpartum period and to carry out correlation analysis with standard coagulogram parameters. Patients/Methods: We examined 229 women in Krasnoyarsk region; they were divided into 5 groups: nonpregnant (control), pregnant women in II and III trimesters, women in early postpartum period after cesarean section and after vaginal delivery. All women were comparable in age, body mass index, and concomitant pathology. Reference intervals were calculated either as the mean and standard deviation (for normal distribution), or as the median and 2.5 and 97.5% percentiles (for abnormal distribution). Results: The study confirmed hemostasis hypercoagulation changes during pregnancy and in early postpartum period. ROTEM parameters in women in III trimester of pregnancy and in early postpartum period differ significantly from those in non-pregnant women. Differences between ROTEM parameters in puerperants, regardless of the delivery method, not found. The correlation between ROTEM parameters and traditional laboratory coagulation tests revealed a relationship between clot density amplitude in FIBTEM test and Klaus fi brinogen level. Conclusions: Reference intervals of ROTEM parameters in women of Krasnoyarsk region are presented. A correlation was found between ROTEM parameters and fibrinogen level

scholarly journals Perioperative coagulation profile in living liver donors as assessed by rotational thromboelastometry

2010 ◽  
pp. NA-NA ◽  
Author(s):  
Glauber Gouvêa ◽  
Rodrigo Diaz ◽  
Lúcio Auler ◽  
Renato Toledo ◽  
André Soluri ◽  
...  
Keyword(s):  
Rotational Thromboelastometry ◽  
Coagulation Profile ◽  
Living Liver Donors ◽  
Liver Donors

scholarly journals The Utilization of Viscoelastic Testing to Guide Blood Component Therapy and Adjunctive Hemostatic Therapy for Postpartum Hemorrhage: A Narrative Review

2019 ◽  
pp. 272-286
Author(s):  
Baumgartner S ◽  
Shariff F ◽  
Vande Lune SA ◽  
Zackariya N ◽  
Grisoli A ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Point Of Care ◽  
Narrative Review ◽  
Blood Component ◽  
Clinical Parameters ◽  
Rotational Thromboelastometry ◽  
Coagulation Tests ◽  
Blood Component Therapy ◽  
History Of ◽  
Hemostatic Therapy

This narrative review discusses the history of the pathophysiologic principles and utilization of point-of-care (POC) viscoelastic tests (VETs) in the definition and treatment of postpartum hemorrhage (PPH). This paper addresses the epidemiology of PPH, describes the hemostatic changes that occur in pregnancy and in PPH, and demonstrates the utilization of viscoelastic testing in the identification and treatment of patients with PPH. Additionally, a description of rotational thromboelastometry (ROTEM) and thromboelastography (TEG), the two most commonly used VETs, is detailed in this paper. VETs have only recently been used to guide blood component therapy (BCT) in trauma in the last decade. The recent increased utilization of VETs to guide BCT in PPH is following a similar trend with a delay of ten years. In a similar fashion to the trauma literature, which expanded greatly within this last decade, the literature concerning the use of VETs in PPH has also increased in the last few years. However, because of differing pathophysiologies associated with the coagulopathy of PPH verses traumatic-induced coagulopathy (TIC), utilization of VETs has been more refined and focused on the VETs’ capacity to determine low fibrinogen and to guide the utilization of blood components and prohemostatic agents. The identification and treatment of PPH depends on clinical parameters, conventional coagulation tests (CCTs) including Clauss fibrinogen, and VETs. Successful treatment of PPH will no doubt include utilization of all three strategies with an increasing utilization of VETs in the future.

scholarly journals A new era of thromboelastometry

2017 ◽  
Vol 15 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Tomaz Crochemore ◽  
Felipe Maia de Toledo Piza ◽  
Roseny dos Reis Rodrigues ◽  
João Carlos de Campos Guerra ◽  
Leonardo José Rolim Ferraz ◽  
...  
Keyword(s):  
Activated Partial Thromboplastin Time ◽  
Allogeneic Blood ◽  
Effective Control ◽  
Common Complication ◽  
Transfusion Therapy ◽  
Rotational Thromboelastometry ◽  
Goal Directed Therapy ◽  
New Era ◽  
Coagulation Tests ◽  
Severe Hemorrhage

ABSTRACT Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients. Viscoelastic tests such as thromboelastography and rotational thromboelastometry allow rapid detection of coagulopathy and goal-directed therapy with specific hemostatic drugs. The new era of thromboelastometry relies on its efficacy, practicality, reproducibility and cost-effectiveness to establish itself as the main diagnostic tool and transfusion guide in patients with severe active bleeding.

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

2020 ◽  
Vol 46 (02) ◽  
pp. 134-146 ◽  
Author(s):  
Jan Hartmann ◽  
Mark Walsh ◽  
Anne Grisoli ◽  
Anthony V. Thomas ◽  
Faisal Shariff ◽  
...  
Keyword(s):  
Trauma Patient ◽  
Clinical Outcomes ◽  
Blood Product ◽  
Blood Component ◽  
Trauma Resuscitation ◽  
Rotational Thromboelastometry ◽  
Trauma Induced Coagulopathy ◽  
Coagulation Tests ◽  
Blood Component Therapy ◽  
Compare And Contrast

AbstractThis article explores the application of viscoelastic tests (VETs) in trauma-induced coagulopathy and trauma resuscitation. We describe the advantages of VETs over conventional coagulation tests in the trauma setting and refer to previous disciplines in which VET use has reduced blood product utilization, guided prohemostatic agents, and improved clinical outcomes such as the mortality of critically bleeding patients. We describe different VETs and provide guidance for blood component therapy and prohemostatic therapy based on specific VET parameters. Because the two most commonly used VET systems, rotational thromboelastometry and thromboelastography, use different activators and have different terminologies, this practical narrative review will directly compare and contrast these two VETs to help the clinician easily interpret either and use the interpretation to determine hemostatic integrity in the bleeding trauma patient. Finally, we anticipate the future of new viscoelastic technologies that can be used in this setting.

scholarly journals COVID-19 Infection-Related Coagulopathy and Viscoelastic Methods: A Paradigm for Their Clinical Utility in Critical Illness

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 817 ◽  
Author(s):  
Argirios E. Tsantes ◽  
Andreas G. Tsantes ◽  
Styliani I. Kokoris ◽  
Stefanos Bonovas ◽  
Frantzeska Frantzeskaki ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Small Sample ◽  
Close Monitoring ◽  
Rotational Thromboelastometry ◽  
Coagulation Tests ◽  
Attractive Option ◽  
Small Sample Sizes ◽  
Fibrinolysis Shutdown ◽  
Insight Into

Hypercoagulability and thrombosis remain a challenge to diagnose and treat in severe COVID-19 infection. The ability of conventional global coagulation tests to accurately reflect in vivo hypo- or hypercoagulability is questioned. The currently available evidence suggests that markedly increased D-dimers can be used in identifying COVID-19 patients who may need intensive care unit (ICU) admission and close monitoring or not. Viscoelastic methods (VMs), like thromboelastography (TEG) and rotational thromboelastometry (ROTEM), estimate the dynamics of blood coagulation. The evaluation of coagulopathy by VMs in severe COVID-19 infection seems an increasingly attractive option. Available evidence supports that COVID-19 patients with acute respiratory failure suffer from severe hypercoagulability rather than consumptive coagulopathy often associated with fibrinolysis shutdown. However, the variability in definitions of both the procoagulant profile and the clinical outcome assessment, in parallel with the small sample sizes in most of these studies, do not allow the establishment of a clear association between the hypercoagulable state and thrombotic events. VMs can effectively provide insight into the pathophysiology of coagulopathy, detecting the presence of hypercoagulability in critically ill COVID-19 patients. However, it remains unknown whether the degree of coagulopathy can be used in order to predict the outcome, establish a diagnosis or guide anticoagulant therapy.

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