Saner Fuat H
Crit Care. 2014 Dec 26;18(6):706. doi: 10.1186/s13054-014-0706-7.
The study by Hincker and colleagues indicated that the perioperative use of rotational thrombelastometry (ROTEM™) could predict thromboembolic events in 90% of the cases in non-cardiac surgery. Viscoelastic tests (VETs)--ROTEM™ and thrombelastography (TEG™)--are used mainly to predict bleeding complications. Most conventional coagulation tests, like prothrombin time and activated partial thromboplastin time, can identify a disturbance in plasmatic hemostasis. However, the relevance of these assays is limited to the initiation phase of coagulation, whereas VETs are designed to assess the whole clotting kinetics and strength of the whole blood clot and reflect more the interaction between procoagulants, anticoagulants, and platelets. The first reports about VET and hypercoagulable state were published more than 25 years ago. Since then, several studies with different quality and sample size have been published, sometimes with conflicting results. A systematic review about hypercoagulable state and TEG™ indicated that further studies are needed to recommend VETs as a screening tool to predict postoperative thrombosis.
欣克及其同事的研究表明，在非心脏手术中，围手术期使用旋转血栓弹力图（ROTEM™）能够在90%的病例中预测血栓栓塞事件。黏弹性检测（VETs）——旋转血栓弹力图（ROTEM™）和血栓弹力描记图（TEG™）——主要用于预测出血并发症。大多数传统凝血检测，如凝血酶原时间和活化部分凝血活酶时间，能够识别血浆止血功能的紊乱。然而，这些检测的相关性仅限于凝血的起始阶段，而VETs旨在评估全血凝血的整个动力学过程和血凝块强度，更多地反映促凝剂、抗凝剂和血小板之间的相互作用。关于VET与高凝状态的首批报告发表于25年多以前。从那时起，已经发表了几项质量和样本量各异的研究，结果有时相互矛盾。一项关于高凝状态和血栓弹力描记图（TEG™）的系统评价表明，需要进一步开展研究，以推荐将VETs作为预测术后血栓形成的筛查工具。
