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thromboelastometry during Labor and after Delivery

Open Journal of Anesthesiology 2013年第4期3卷 218-223页

作者： Gabriele Tola Silvia Sirparo Luca Ruggeri Giorgio Capogna Department of Anesthesiology Città di Roma Hospital Rome Italy.

The normal values of thromboelastometry (MonoTEM-A?, Framar Hemologix) in pregnancy have not been determined. The aim of this study was to establish the reference ranges for the thromboelastometer in healthy pregnant women during labor and after delivery. After ethical institutional approval and informed consent, we collected blood samples for analysis from 95 healthy labouring women and 40 volunteers (non pregnant women, control group). A sample of 360 μL of whole native blood was tested using the MonoTEM-A? equipment and analyzed within 4 min, at 37℃. We recorded: R = time to initial fibrin formation;K = time to initial clot formation;Alpha Angle = acceleration of clot formation and MA = strength of the blood clot. When compared to the control group, R and K values were lower in women during labor and after the delivery. The Alpha angle and MA values were higher in the laboring women and in the same women after delivery as compared to the control group. Our study determined the reference ranges for the MonoTEM-A? in pregnancy during labor and immediately after the delivery. Data obtained from thromboelastometry confirm the hypercoagulability status in pregnancy and the puerperium. MonoTEM-A? thromboelastometry may be a very useful tool to assess the clotting activity in this patient setting.

关键词： Pregnancy Labor thromboelastometry

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Thromboelastography: Current Applications, Future Directions

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Open Journal of Anesthesiology 2013年第1期3卷 23-27页

作者： Linda M. Trapani The Brooklyn Hospital Center Brooklyn USA.

Analyzing coagulability often hinges on patient surveillance using prothrombin time (PT) or international normalized ratio (INR) and activated partial thromboplastin time (aPTT) to monitor the extrinsic and intrinsic coagulation pathways, respectively A more complete assessment, however, can often be obtained using thromboelastography (TEG), a coagulation assay that evaluates the efficiency of clot formation, as well as the viscoelastic properties of the clot. Developed by Dr. Helmut Hartert in 1948 at the UniversityofHeidelberg, it provides information regarding hemostasis as a dynamic process [1,2]. Here, the TEG technique will be described, as well as its current applications and future directions for its use.

关键词： Thromboelastography Rotational thromboelastometry Cardiopulmonary Bypass Coagulation Index Adenosine Diphosphate Prothrombin Time Partial Thromboplastin Time International Normalized Ratio

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Single vs double antiplatelet therapy in acute coronary syndrome: Predictors of bleeding after coronary artery bypass grafting

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World Journal of Cardiology 2015年第9期7卷 571-578页

作者： Vincenzo Tarzia Giacomo Bortolussi Edward Buratto Carla Paolini Carlo Dal Lin Giulio Rizzoli Tomaso Bottio Gino Gerosa Division of Cardiac Surgery Department of Cardiac Thoracic and Vascular Sciences University of Padua Medical School Division of Cardiology Department of Cardiac Thoracic and Vascular Sciences University of Padua Medical School

AIM:To investigate the contribution of anti-platelet therapy and derangements of pre-operative classical coagulation and thromboelastometry parameters to major bleeding post-coronary artery bypass grafting(CABG).METHODS:Two groups of CABG patients were studied:Group A,treated with aspirin alone(n=50),and Group B treated with aspirin and clopidogrel(n=50).Both had similar preoperative,clinical,biologic characteristics and operative *** coagulation parameters and rotational thromboelastometry(ROTEM)profiles were determined preoperatively for both groups and the same heparin treatment was *** profiles(INTEM and EXTEM assays)were analyzed,both for traditional parameters,and thrombin generation potential,expressed by area-under-curve(AUC).RESULTS:There was no significant difference betweenrates of major bleeding between patients treated with aspirin alone,compared with those treated with aspirin and clopidogrel(12%vs 16%,P=0.77).In the 14 cases of major bleeding,pre-operative classic coagulation and traditional ROTEM parameters were *** we observed that the AUC in the EXTEM test was significantly lower in bleeders(5030±1115 Ohm*min)than non-bleeders(6568±548Ohm*min)(P<0.0001).CONCLUSION:We observed that patients with a low AUC value were at a significantly higher risk of bleeding compared to patients with higher AUC,regardless of antiplatelet *** suggests that thrombin generation potential,irrespective of the degree of platelet inhibition,correlates with surgical bleeding.

关键词： Platelet inhibitors thromboelastometry Bleeding Ac

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