Tantry Thrivikrama P, Hande Milan, Rao Pooja K, Shenoy Sunil P
Department of Anaesthesiology, A J Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, Karnataka, India.
Department of Anaesthesiology, All India Institute of Medical Sciences, Kunraghat, Ghorakhpur, Uttar Pradesh, India.
Saudi J Anaesth. 2025 Jul-Sep;19(3):432-436. doi: 10.4103/sja.sja_773_24. Epub 2025 Jun 16.
Reports on intraoperative coagulation monitoring using viscoelastic testing methods are scarce in oncosurgical patients. Evidence-based clinical reports with the use of Sonoclot and subsequent corrections of coagulation abnormalities in above population are not available in the literature. We report here records of altered coagulation in 10 subjects with massive hemorrhage. Detection of intraoperative coagulation abnormalities was done using activated clotting time, clot rate, and platelet function. The most common Sonoclot signature abnormality found in our series was a poorly formed, dull, and rounded "peak," indicative of irregularities of fibrin formation. Dilutional coagulopathy and hyper-fibrinolysis events too were recorded in few subjects. Appropriate transfusions with blood products were considered based on Sonoclot curve assessment. All subjects had adequate recovery. We conclude that the Sonoclot analysis demonstrates potential for optimizing blood product use in oncosurgical patients with massive hemorrhage, warranting further research to establish standardized protocols and quantify its impact.
关于在肿瘤外科手术患者中使用粘弹性测试方法进行术中凝血监测的报告很少。目前文献中没有关于使用Sonoclot以及随后对上述人群凝血异常进行纠正的循证临床报告。我们在此报告10例大出血患者凝血改变的记录。使用活化凝血时间、凝血速率和血小板功能来检测术中凝血异常。在我们的系列研究中发现的最常见的Sonoclot特征异常是形成不良、暗淡且圆润的“峰”，这表明纤维蛋白形成不规则。少数受试者还记录到稀释性凝血病和高纤维蛋白溶解事件。根据Sonoclot曲线评估考虑适当输注血液制品。所有受试者均恢复良好。我们得出结论，Sonoclot分析显示了在肿瘤外科大出血患者中优化血液制品使用的潜力，有必要进一步研究以建立标准化方案并量化其影响。
