title: Thromboelastography-guided transfusion Therapy in the trauma patient.
abstract: This article presents thromboelastography (TEG) as an important assay to incorporate into anesthesia practice for development of evidence-based therapy of trauma patients receiving blood transfusions. The leading cause of death worldwide results from trauma. Hemorrhage is responsible for 30% to 40% of trauma mortality and accounts for almost 50% of the deaths occurring in the initial 24 hours following the traumatic incident. On admission, 25% to 35% of trauma patients present with coagulopathy, which is associated with a sevenfold increase in morbidity and mortality. The literature supports that routine plasma-based routine coagulation tests, such as prothrombin time, activated partial thromboplastin time, and international normalized ratio, are inadequate for monitoring coagulopathy and guided transfusion therapy in trauma patients. A potential solution is incorporating the use of the TEG assay into the care of trauma patients to render evidence-based therapy for patients requiring massive blood transfusions. Analysis with TEG provides a complete picture of hemostasis, which is far superior to isolated, static conventional tests. The result is a fast, well-designed, and precise diagnosis enabling more cost-effective treatment, improved clinical outcome, accurate use of blood products, and pharmaceutical therapies at the point of care.
authors: Sheridan Healthcare, Kendall Regional Medical Center, Miami, Florida, USA.
authors: Charice
authors: C
authors: Brazzel
mesh_terms: D001803:Blood Transfusion / Q000379:methods*; D055317:Evidence-Based Practice; D006470:Hemorrhage / Q000401:mortality / Q000628:therapy*; D006487:Hemostasis; D006801:Humans; D009719:Nurse Anesthetists; D013916:Thrombelastography / Q000379:methods*; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*