Title |
A new era of thromboelastometry
|
---|---|
Published in |
Einstein (São Paulo), June 2017
|
DOI | 10.1590/s1679-45082017md3130 |
Pubmed ID | |
Authors |
Tomaz Crochemore, Felipe Maia de Toledo Piza, Roseny dos Reis Rodrigues, João Carlos de Campos Guerra, Leonardo José Rolim Ferraz, Thiago Domingos Corrêa |
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. RESUMO A hemorragia grave com necessidade de transfusão de sangue e componentes é uma complicação frequente na unidade de terapia intensiva e está associada ao aumento da morbidade e da mortalidade. A identificação adequada e o tratamento precoce da causa específica da coagulopatia tornam-se fundamentais para o controle efetivo da hemorragia, racionalizando a utilização de sangue e componentes, e desta forma, prevenindo a ocorrência de efeitos adversos. Testes convencionais da coagulação (tempo de ativação de protrombina e tempo de tromboplastina parcial ativada) apresentam limitações para prever sangramento e guiar a terapia transfusional em pacientes graves. Testes viscoelásticos como a tromboelastografia e tromboelastometria rotacional permitem a rápida detecção da coagulopatia e orientam a terapia de forma individualizada, alvo dirigida com drogas hemostáticas específicas. A nova era da tromboelastometria confia na sua eficácia, praticidade, reprodutibilidade e custo-eficácia para se firmar como a principal ferramenta diagnóstica e guia transfusional em pacientes com sangramento ativo grave. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 115 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 16 | 14% |
Researcher | 12 | 10% |
Student > Postgraduate | 11 | 10% |
Other | 10 | 9% |
Student > Doctoral Student | 8 | 7% |
Other | 20 | 17% |
Unknown | 38 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 50 | 43% |
Biochemistry, Genetics and Molecular Biology | 6 | 5% |
Engineering | 5 | 4% |
Nursing and Health Professions | 4 | 3% |
Agricultural and Biological Sciences | 3 | 3% |
Other | 7 | 6% |
Unknown | 40 | 35% |