Leeper Christine M, Gaines Barbara A
Department of Surgery, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Dr, 4401 Penn Ave, Pittsburgh, Pennsylvania 15224.
Department of Surgery, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Dr, 4401 Penn Ave, Pittsburgh, Pennsylvania 15224.
Semin Pediatr Surg. 2017 Feb;26(1):8-13. doi: 10.1053/j.sempedsurg.2017.01.004. Epub 2017 Jan 5.
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited. Here, we discuss the mechanics and interpretation of VHAs as well as the use of VHAs in data-driven resuscitation of pediatric trauma patients. Novel research on fibrinolysis states after injury as well as hypercoagulable state diagnosed with VHAs are presented.
黏弹性止血检测（VHA），如血栓弹力图（TEG）和旋转血栓弹力图（ROTEM），是全血检测，能以数字和图形方式描绘功能性凝血。快速VHA技术的发展使首个数据点在检测开始后几分钟内就能得出结果，这增加了这些检测在创伤患者治疗中的实用性。成人和儿科中心都已将VHA纳入创伤复苏和输血方案。关于VHA在受伤儿童中的应用的文献有限。在此，我们讨论VHA的机制和解读，以及VHA在儿科创伤患者数据驱动复苏中的应用。还介绍了关于损伤后纤溶状态以及通过VHA诊断的高凝状态的新研究。
