[Thromboelastometry--a new method supporting the therapeutical decisions in the coagulopathy based on the Hartet's thromboelastography].
Thromboelastometry is a diagnostic method presenting in graphs and numbers the dynamics of hemostasis and physical properties of the clot forming. Thromboelastometry allows quick and complete assessment of clotting and fibrinolysis mechanism respecting share of coagulation and fibrinolytic factors and also platelets. Interpretation is based on comparative analysis of model data from computer memory with graphs and numeric data that present clot formation and fibrinolysis in time periods. Graphic presentation of quality and dynamics of coagulation process allow to understand its disorders caused for different reasons, like coagulation factors deficiency, thrombocytopenia, massive bleeding and transfusion or sometimes hypothermia. Measuring device used for thromboelastometry is mobile and makes possible to test blood by a patient bed. By introducing specialist reagents that activate clotting in vitro it is possible to shorten the diagnostic period to 15 minutes therefore multiple patient hemostasis controls can be achieved in real time. Quick diagnostic and possibility of assessment an influence of applied treatment on coagulation process allow to make proper therapeutic decisions in patients with coagulopathy. Hemostasis image and reference to clinical situation might be helpful in diagnosis if there is a surgical bleeding or there is a bleeding released by coagulation and fibrinolytic disorders. Thromboelastometry contributes not only to widen knowledge about complex mechanics of coagulation disorders but also to reduce usage of blood and its products. Thromboelastograhic examinations play a major role in the documentation of coagulation disorders treatment. In order to widen use of this method in clinical practice the algorithms are created, based on thromboelastometry and thromboelatograhy results. These can indicate type and quantity of blood products and medicines that are necessary to administer. Thromboelastometry is applied in many medical disciplines like cardiothoracic surgery, transplant surgery, obstetrics, multiorgan failures, vascular surgery and intensive care. In this method specialistic laboratory education is unnecessary.
Medical University of Warsaw, Department of Anesthesiology and Intensive Care, Poland. jtrzebicki@gmail.com
Janusz
J
Trzebicki
Gabriela
G
Kuzmińska
Piotr
P
Domagała
D000925:Anticoagulants / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000188:drug therapy; D003626:Data Display; D004867:Equipment Design; D006801:Humans; D013916:Thrombelastography / Q000295:instrumentation* / Q000379:methods*
D000925:Anticoagulants