[Possibilities and limitations of thrombelastometry/-graphy].
Thrombelastometry/-graphy provides information about clot strength and stability. Modified thrombelastometry/-graphy improved standardisation and diagnostic information using this system. Heparinase modified thrombelastometry/-graphy allows estimation of heparin. The introduction of FIBTEM on the ROTEM first allows a clear estimation of the plasmatic and the platelet component of clot strength, which may be of interest in managing haemostasis in perioperative setting. In this context the meaning of fibrinogen should be evaluated. As our clinical data show there is no predictive value of elevated D-dimers to hyperfibrinolysis in perioperative setting. However, thrombelastometry/-graphy do not deteckt disturbances in primary haemostasis such as von Willebrand Syndrom. The effect of acetylsalicylacid and clopidogrel do not have any influence on thrombelastometry/-graphy, as well. GPIIb/IIIa-Antagonists such as ReoPro may reduce clot strength at high dosis. A similar effect may be expected in severe M. Glanzmann. The correlation between coagulation time in thrombelastometry/-graphy (CT/r-value) to conventional coagulation may be low because of different activators used. The introduction of rotationthrombelastometry (ROTEM) provides a stable system suitable for bedside-monitoring.
Lang
T
T
Abteilung für Anästhesie, Medizinische Hochschule Hannover, Germany. tl@werlhof-institut.de
von Depka
M
M
D001777:Blood Coagulation; D006801:Humans; D010976:Platelet Count; D013916:Thrombelastography / Q000379:methods*