The Role of TEG and ROTEM in Damage Control Resuscitation

Brill, Jason B. (author): Univ Texas Hlth Sci Ctr Houston, TX 77030 USA,Department of Surgery, University of Texas Health Science Center, Houston, Texas

Brenner, Megan (author): Univ Calif Riverside, CA 92521 USA,Department of Surgery, University of California Riverside, Riverside, California, USA

Duchesne, Juan (author): Dept Surg Tulane, LA USA,Division Chief Acute Care Surgery, Department of Surgery Tulane, New Orleans, Louisiana, USA

Roberts, Derek (author): Dept Surg Tulane, LA USA,Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada

Ferrada, Paula (author): VCU Surgery Trauma, Critical Care and Emergency Surgery, Richmond, Virginia, USA

Hörer, Tal M., 1971- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiothoracic and Vascular Surgery,Orebro Univ Hosp, Sweden; Univ Orebro, Sweden

Kauvar, David (author): San Antonio Mil Med Ctr, TX USA,Vascular Surgery Service, San Antonio Military Medical Center, San Antonio, Texas, USA

Khan, Mansoor (author): Royal Ctr Def Med, England,Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, UK

Kirkpatrick, Andrew (author): Univ Calgary, Canada; Foothills Med Ctr, Canada; Canadian Forces Hlth Serv, Canada,Regional Trauma Services Foothills Medical Centre; Departments of Surgery, Critical Care Medicine, University of Calgary, Calgary, Alberta, Candada; Canadian Forces Health Services, Ottawa, Canada

Ordonez, Carlos (author): Univ Valle, Colombia,Fundación Valle del Lili, Division of Trauma and Acute Care Surgery, Department of Surgery. Universidad del Valle, Colombia

Perreira, Bruno (author): Univ Estadual Campinas, Brazil,Department of Surgery and Surgical Critical Care, University of Campinas, Campinas, Brazil

Pirouzram, Artai (author): Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland,Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital, Linköping, Sweden

Cotton, Bryan A. (author): Univ Texas Hlth Sci Ctr Houston, TX 77030 USA,Department of Surgery, University of Texas Health Science Center, Houston, Texas

(creator_code:org_t)

LIPPINCOTT WILLIAMS & WILKINS, 2021
2021
English.
In: Shock. - : LIPPINCOTT WILLIAMS & WILKINS. - 1073-2322 .- 1540-0514. ; 56:1S, s. 52-61

Related links:: https://doi.org/10.1...; show more...; https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; show less...

Abstract Subject headings

Trauma-induced coagulopathy is associated with very high mortality, and hemorrhage remains the leading preventable cause of death after injury. Directed methods to combat coagulopathy and attain hemostasis are needed. The available literature regarding viscoelastic testing, including thrombelastography (TEG) and rotational thromboelastometry (ROTEM), was reviewed to provide clinically relevant guidance for emergency resuscitation. These tests predict massive transfusion and developing coagulopathy earlier than conventional coagulation testing, within 15 min using rapid testing. They can guide resuscitation after trauma, as well. TEG and ROTEM direct early transfusion of fresh frozen plasma when clinical gestalt has not activated a massive transfusion protocol. Reaction time and clotting time via these tests can also detect clinically significant levels of direct oral anticoagulants. Slowed clot kinetics suggest the need for transfusion of fibrinogen via concentrates or cryoprecipitate. Lowered clot strength can be corrected with platelets and fibrinogen. Finally, viscoelastic tests identify fibrinolysis, a finding associated with significantly increased mortality yet one that no conventional coagulation test can reliably detect. Using these parameters, guided resuscitation begins within minutes of a patients arrival. A growing body of evidence suggests this approach may improve survival while reducing volumes of blood products transfused.

By the author/editor: Brill, Jason B.; Brenner, Megan; Duchesne, Juan; Roberts, Derek; Ferrada, Paula; Hörer, Tal M., 1 ...; show more...; Kauvar, David; Khan, Mansoor; Kirkpatrick, And ...; Ordonez, Carlos; Perreira, Bruno; Pirouzram, Artai; Cotton, Bryan A.; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Dermatology and ...

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