Dick A, Schwaiger M, Jámbor C
Arbeitsgruppe Perioperative Hämostase, Abteilung für Transfusionsmedizin und Hämostaseologie, Klinik für Anästhesiologie, Klinikum der Universität München, 81377 München.
Hamostaseologie. 2010 May;30(2):91-5.
Thromboelastography/thromboelastometry (TEG/ROTEM) is widely used in near-patient setting, especially in perioperative and intensive care medicine for the management of acute bleeding. Until now a comprehensive quality management especially an external quality control of TEG/ROTEM results is not established. Here we report about our results of a pilot survey performed in 2008 and 2009 integrated in the External Quality Assessment Schemes (EQAS) performed by INSTAND. According to this first EQAS data ROTEM results can be controlled in external quality schemes using lyophilized plasma samples. The clot firmness (A20) and clot formation kinetics characterized by the alpha-angle showed very good reproducibility both between the participants and between different surveys. Variations for CT and CFT were considerably higher especially in the plasma sample with reduced fibrinogen level. Regular participation in an external quality assurance will help to confirm this beneficial technology in emergency settings.
血栓弹力图/血栓弹力测定法(TEG/ROTEM)在床旁检测中被广泛应用,尤其是在围手术期和重症监护医学中用于急性出血的管理。到目前为止,尚未建立全面的质量管理,特别是TEG/ROTEM结果的外部质量控制。在此,我们报告2008年和2009年进行的一项试点调查结果,该调查纳入了由INSTAND开展的外部质量评估计划(EQAS)。根据首批EQAS数据,可使用冻干血浆样本在外部质量计划中对ROTEM结果进行控制。参与者之间以及不同调查之间,以α角为特征的血凝块硬度(A20)和血凝块形成动力学显示出非常好的可重复性。CT和CFT的变化明显更高,尤其是在纤维蛋白原水平降低的血浆样本中。定期参与外部质量保证将有助于在紧急情况下确认这项有益技术。