Comprehensive evaluation of coagulability using thromboelastography in four patients with essential thrombocythemia.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-05-17 DOI:10.1186/s40981-025-00789-6

Shuji Kawamoto, Tsuguhiro Matsumoto, Yohei Chiwata, Chikashi Takeda, Eriko Kusudo, Moritoki Egi

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引用次数: 0

Abstract

Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by increased platelet count and risk of thrombosis and bleeding, which necessitates careful perioperative management. However, there are no standardized guidelines for perioperative antithrombotic therapy, and optimal preoperative evaluation remains unclear. In this report, we evaluate the utility of thromboelastography (TEG®6 s) for assessing coagulation and platelet function in ET patients undergoing surgery.

Case presentation: Four ET patients (platelet counts: 289,000-833,000/µL) underwent thromboelastography at anesthesia induction. Two had normal coagulation, while two had a hypercoagulable state undetected by conventional tests. Hypercoagulability was observed in patients who discontinued anticoagulants or antiplatelets preoperatively.

Conclusions: Thromboelastography identified thrombotic tendencies not evident with conventional coagulation tests, suggesting its potential for perioperative risk assessment in ET patients. This approach may improve individualized coagulation management beyond use of platelet counts and standard tests. Further studies are needed to establish the role of thromboelastography in optimizing perioperative antithrombotic strategies.

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应用血小板弹性成像综合评价4例原发性血小板增多症患者的凝血能力。

背景：原发性血小板增多症（ET）是一种骨髓增生性肿瘤，其特征是血小板计数增加，血栓形成和出血的风险，需要谨慎的围手术期治疗。然而，围手术期抗血栓治疗尚无标准化指南，最佳术前评估仍不清楚。在本报告中，我们评估了血栓弹性成像（TEG®6 s）在评估ET手术患者凝血和血小板功能方面的应用。病例介绍：4例ET患者（血小板计数：289,000-833,000/µL）在麻醉诱导下进行了血栓弹性成像。2例凝血正常，2例高凝血，常规检测未发现。在术前停用抗凝或抗血小板药物的患者中观察到高凝性。结论：血栓弹性成像识别出传统凝血试验不明显的血栓倾向，提示其在ET患者围手术期风险评估中的潜力。除了使用血小板计数和标准测试外，这种方法可以改善个体化凝血管理。需要进一步的研究来确定血栓弹性成像在优化围手术期抗血栓策略中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.