The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma PatientsReportar como inadecuado




The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

The Scientific World JournalVolume 2012 2012, Article ID 821794, 7 pages

Clinical Study

Department of Emergency Medicine, University Hospital Inselspital Bern, 3010 Bern, Switzerland

Haemonetics Corporation, 400 Wood Rd., Braintree, MA 02184, USA

Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA

Received 23 October 2011; Accepted 17 November 2011

Academic Editors: T. Drabek and L. G. Graff

Copyright © 2012 Victor Jeger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. To guide the administration of blood products, coagulation screening of trauma patients should be fast and accurate. The purpose of this study was to identify the correlation between CCT and TEG in trauma, to determine which CCT or TEG parameter is most sensitive in predicting transfusion in trauma, and to define TEG cut-off points for trauma care. Methods. A six-month, prospective observational study of 76 adult patients with suspected multiple injuries was conducted at a Level 1 trauma centre of a university hospital. Physicians blinded to TEG results made the decision to transfuse based on clinical evaluation. Results. The study results showed that conventional coagulation tests correlate moderately with Rapid TEG parameters R: 0.44–0.61. Kaolin and Rapid TEG were more sensitive than CCTs, and the Rapid TEG α-Angle was identified as the single parameter with the greatest sensitivity 84% and validity 77% at a cut-off of 74.7 degrees. When the Rapid TEG α-Angle was combined with heart rate >75 bpm, or haematocrit < 41%, sensitivity 84%, 88% and specificity 75%, 73% were improved. Conclusion. Cutoff points for transfusion can be determined with the Rapid TEG α-Angle and can provide better sensitivity than CCTs, but a larger study population is needed to reproduce this finding.





Autor: Victor Jeger, Sandra Willi, Tun Liu, Daniel D. Yeh, Marc De Moya, Heinz Zimmermann, and Aristomenis K. Exadaktylos

Fuente: https://www.hindawi.com/



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