Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

Jan Hartmann; Mark Walsh; Anne Grisoli; Anthony V. Thomas; Faisal Shariff; Ross McCauley; Stefani Vande Lune; Nuha Zackariya; Shivani Patel; Michael S. Farrell; Sherry Sixta; Robert March; Edward Evans; Rebecca Tracy; Elena Campello; Ecaterina Scărlătescu; Vanessa Agostini; João Dias; Sarah Greve; Scott Thomas

doi:10.1055/s-0040-1702171

Seminars in Thrombosis and Hemostasis, Inhaltsverzeichnis

Semin Thromb Hemost 2020; 46(02): 134-146
DOI: 10.1055/s-0040-1702171

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

Jan Hartmann

¹Haemonetics Corporation, Boston, Massachusetts

,

Mark Walsh

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

³Memorial Hospital Trauma Center, South Bend, Indiana

⁴W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, Indiana

,

Anne Grisoli

⁵Indiana University School of Medicine—South Bend Campus, Notre Dame, Indiana

,

Anthony V. Thomas

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

³Memorial Hospital Trauma Center, South Bend, Indiana

,

Faisal Shariff

⁵Indiana University School of Medicine—South Bend Campus, Notre Dame, Indiana

,

Ross McCauley

⁵Indiana University School of Medicine—South Bend Campus, Notre Dame, Indiana

,

Stefani Vande Lune

⁵Indiana University School of Medicine—South Bend Campus, Notre Dame, Indiana

,

Nuha Zackariya

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

³Memorial Hospital Trauma Center, South Bend, Indiana

,

Shivani Patel

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

³Memorial Hospital Trauma Center, South Bend, Indiana

,

Michael S. Farrell

⁶Department of Trauma, Surgery, and Critical Care Medicine, Christiana Care Health Services, Wilmington, Delaware

,

Sherry Sixta

⁶Department of Trauma, Surgery, and Critical Care Medicine, Christiana Care Health Services, Wilmington, Delaware

,

Robert March

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Edward Evans

²Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Rebecca Tracy

⁷Department of Emergency Medicine, Southern Illinois University School of Medicine, Springfield, Illinois

,

Elena Campello

⁸Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padua University Hospital, Padua, Italy

,

Ecaterina Scărlătescu

⁹Department of Anaesthesia and Intensive Care, Fundeni Clinical Institute, Bucharest, Romania

,

Vanessa Agostini

¹⁰Department of Clinical Pathology, Transfusion Medicine Cesena/Forlì and Blood Establishment, Azienda USL della Romagna, Romagna, Italy

,

João Dias

¹¹Haemonetics S. A., Signy, Switzerland

,

Sarah Greve

¹Haemonetics Corporation, Boston, Massachusetts

,

Scott Thomas

³Memorial Hospital Trauma Center, South Bend, Indiana

⁴W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, Indiana

› Institutsangaben

Abstract

This 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.

Keywords

viscoelastic testing - thromboelastography - rotational thromboelastometry - trauma-induced coagulopathy - massive transfusion - shock

Volltext

Referenzen

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