Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
-
Blood Coagul. Fibrinolysis · Jan 2014
Effects of recombinant activated factor VIIa on abdominal trauma patients.
Recombinant activated factor VIIa (rFVIIa) has been highlighted by correcting uncontrollable traumatic haemorrhage. Compared with routine coagulation tests, thromboelastography (TEG) can evaluate the coagulation function of trauma patients more rapidly, accurately and comprehensively, and can also diagnose trauma-associated coagulopathy (TAC) in an early stage. Thirty-eight cases conforming to rFVIIa indications were screened according to TEG results and divided into an rFVIIa group (n = 20) and a nonrFVIIa group (n = 18). ⋯ Moreover, significant fewer red blood cells, platelet and fresh frozen plasma were transfused in the rFVIIa group. All patients underwent daily bedside vascular ultrasound screening within a week after haemostatic treatment, of which no thromboembolic events occurred. TEG can sensitively detect TAC. rFVIIa administered goal-directedly guided by TEG is more effectively in correcting TAC and decreasing the amount of blood product transfusion.
-
Blood Coagul. Fibrinolysis · Jan 2014
Multicenter Study Observational StudyPlatelet aggregation following trauma: a prospective study.
We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED). Inclusion criteria were trauma team activation and arterial cannula insertion on arrival. ⋯ An aggregation value of 145 IU by TRAP significantly identified death due to cerebral injury (sensitivity 71% and specificity 76%, P < 0.01) by receiver operating characteristic-curve analysis; the corresponding value of platelet counts for massive transfusion was 189 × 10/l (sensitivity 86%, specificity 75%, P < 0.01). We concluded there was no simple relationship between platelet aggregation and injury severity. Our results indicate that high platelet aggregation values are associated with fatality of cerebral injury.
-
Blood Coagul. Fibrinolysis · Jan 2014
Comparison of arterial and venous whole blood clot initiation, formation, and strength by thromboelastography in anesthetized swine.
Thromboelastography (TEG) analysis was used to determine if differences exist between venous and arterial samples in anesthetized swine, using identical sampling techniques for each of the samples. We hypothesized that TEG parameters would not differ between native whole blood venous and arterial samples. Thirty male Landrace swines were included in the study. ⋯ These differences are important, especially when temporal changes in TEG are utilized to monitor patient stability and fluid therapy protocols using trends in coagulation properties. Taken together, these results suggest that clots are more likely to form at a faster rate in venous samples compared to arterial samples, but the overall clot strength does not differ. Therefore, if TEG analysis is being used to monitor coagulation profiles in a patient, care should be taken to use the same site and technique if results are to be used for comparative purposes.