Document Detail


Coagulation abnormalities in the trauma patient: the role of point-of-care thromboelastography.
MedLine Citation:
PMID:  20978993     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Current recommendations for resuscitation of the critically injured patient are limited by a lack of point-of-care (POC) assessment of coagulation status. Accordingly, the potential exists for indiscriminant blood component administration. Furthermore, although thromboembolic events have been described shortly after injury, the time sequence of post-injury coagulation changes is unknown. Our current understanding of hemostasis has shifted from a classic view, in which coagulation was considered a chain of catalytic enzyme reactions, to the cell-based model (CBM), representing the interplay between the cellular and plasma components of clot formation. Thromboelastography (TEG), a time-sensitive dynamic assay of the viscoelastic properties of blood, closely parallels the CBM, permitting timely, goal-directed restoration of hemostasis via POC monitoring of coagulation status. TEG-based therapy allows for goal-directed blood product administration in trauma, with potential avoidance of the complications resulting from overzealous component administration, as well as the ability to monitor post-injury coagulation status and thromboprophylaxis. This overview addresses coagulation status and thromboprophylaxis management in the trauma patient and the emerging role of POC TEG.
Authors:
Eduardo Gonzalez; Fredric M Pieracci; Ernest E Moore; Jeffry L Kashuk
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Publication Detail:
Type:  Journal Article     Date:  2010-10-26
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  36     ISSN:  1098-9064     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  723-37     Citation Subset:  IM    
Copyright Information:
© Thieme Medical Publishers.
Affiliation:
Department of Surgery, Denver Health Medical Center and University of Colorado School of Medicine, Denver, Colorado, USA.
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