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粘弹性研究:创伤与外科复苏工作的有效工具

Viscoelastic Studies: Effective Tools for Trauma and Surgical Resuscitation Efforts.

作者信息

Salinas Dagoberto

出版信息

AORN J. 2017 Apr;105(4):370-383. doi: 10.1016/j.aorn.2017.01.013.

Abstract

Trauma-induced coagulopathy (TIC) is an abrupt disruption of all hemostatic components of coagulation resulting from severe tissue injury and hypoperfusion. The effective management of TIC has remained elusive to clinicians using traditional laboratory methods, challenging efforts to improve outcomes related to uncontrolled bleeding. Recent initiatives have aimed to reduce TIC-associated morbidity and mortality, further invoking trauma experts to explore innovative modalities in the field of viscoelastic studies, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM). These tests are able to guide proper blood product administration more effectively during trauma and surgical resuscitation compared with conventional laboratory tests. Although TEG and ROTEM are similar tests, inherent differences in their features produce variation in output results. This article calls on the perioperative clinician to evaluate TEG and ROTEM tests and consider their implementation based on the benefits of their application to clinical practice.

摘要

创伤性凝血病(TIC)是由严重组织损伤和低灌注导致的凝血所有止血成分的突然破坏。使用传统实验室方法,临床医生一直难以有效管理TIC,这给改善与失控性出血相关的预后带来了挑战。最近的举措旨在降低TIC相关的发病率和死亡率,进一步促使创伤专家探索粘弹性研究领域的创新模式,如血栓弹力图(TEG)和旋转血栓弹力测定法(ROTEM)。与传统实验室检查相比,这些检查能够在创伤和手术复苏期间更有效地指导正确的血液制品输注。尽管TEG和ROTEM是相似的检查,但它们特性的内在差异会导致输出结果有所不同。本文呼吁围手术期临床医生评估TEG和ROTEM检查,并基于其在临床实践中的应用益处考虑采用这些检查。

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