Thromboelastography (TEG) Point-of-Care Diagnostic for Hemostasis Management

J. Hartmann, D. Mason, Hardean E. Achneck
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引用次数: 21

Abstract

Abstract Thromboelastography is a method of assessing the coagulation status of patients. Unlike standard laboratory–based coagulation tests (eg, prothrombin time and activated partial thromboplastin time), it provides a holistic, functional perspective on the entire coagulation process; and point-of-care application provides results more quickly. Across a wide range of clinical settings, thromboelastography can be used to assess the risk of bleeding or thromboembolic events and to guide management of hemostatic equilibrium. Until recently, the principal system for performing thromboelastography was the TEG 5000 analyzer. The TEG 6s system, which consists of the TEG 6s analyzer and disposable cartridges, measures the same properties as the TEG 5000 and was recently developed to increase the ease and precision with which thromboelastography is performed. By measuring the velocity of clot formation, the strength of the clot, contributions of fibrinogen and platelets to clot strength, and the speed/extent of fibrinolysis, a comprehensive insight into the patient's coagulation status is gained. Treatment can then be individualized to ensure effective coagulation management while avoiding exposure to unnecessary treatment. Subsequently, the effect of treatment can be assessed to determine whether further intervention may be required. We review the clinical use of thromboelastography in trauma, cardiovascular surgery, liver transplantation, obstetrics, congenital bleeding disorders, and other settings. Increased uptake of thromboelastography has the potential to improve standards of patient care and to lead to health economic benefits.
血栓弹性成像(TEG)即时诊断止血管理
摘要血栓弹性成像是一种评估患者凝血状态的方法。不像标准的实验室为基础的凝血试验(例如,凝血酶原时间和活化部分凝血活素时间),它提供了一个整体的,功能的角度对整个凝血过程;即时护理应用可以更快地提供结果。在广泛的临床环境中,血栓弹性成像可用于评估出血或血栓栓塞事件的风险,并指导止血平衡的管理。直到最近,执行血栓弹性成像的主要系统是TEG 5000分析仪。TEG 6s系统由TEG 6s分析仪和一次性药筒组成,测量与TEG 5000相同的性能,最近开发用于提高血栓弹性成像的易用性和精度。通过测量凝块形成的速度、凝块的强度、纤维蛋白原和血小板对凝块强度的贡献以及纤维蛋白溶解的速度/程度,可以全面了解患者的凝血状态。然后可以个体化治疗,以确保有效的凝血管理,同时避免不必要的治疗。随后,可以评估治疗效果,以确定是否需要进一步干预。我们回顾了血栓弹性成像在创伤、心血管手术、肝移植、产科、先天性出血性疾病和其他情况下的临床应用。增加血栓弹性成像有可能提高患者护理标准,并带来健康经济效益。
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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