Limits...
Coagulation testing in the perioperative period.

Thiruvenkatarajan V, Pruett A, Adhikary SD - Indian J Anaesth (2014)

Bottom Line: Perioperative coagulation management is a complex task that has a significant impact on the perioperative journey of patients.While the rapidly available bedside haemoglobin measurements can guide the transfusion of red blood cells, blood product administration is guided by many in vivo and in vitro tests.A proper understanding of the application and interpretation of the coagulation tests is vital for a good perioperative outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, South Australia ; Discipline of Acute Care Medicine, The University of Adelaide, South Australia.

ABSTRACT
Perioperative coagulation management is a complex task that has a significant impact on the perioperative journey of patients. Anaesthesia providers play a critical role in the decision-making on transfusion and/or haemostatic therapy in the surgical setting. Various tests are available in identifying coagulation abnormalities in the perioperative period. While the rapidly available bedside haemoglobin measurements can guide the transfusion of red blood cells, blood product administration is guided by many in vivo and in vitro tests. The introduction of newer anticoagulant medications and the implementation of the modified in vivo coagulation cascade have given a new dimension to the field of perioperative transfusion medicine. A proper understanding of the application and interpretation of the coagulation tests is vital for a good perioperative outcome.

No MeSH data available.


Related in: MedlinePlus

Bio-mechanical working principles behind the three viscoelastic coagulation monitoring devices: (1) blood sample in rotating cup for TEG® and in cuvette for ROTEM® and Sonoclot®, (2) coagulation activator, (3) pin and torsion wire for TEG®, pin and rotating axis for ROTEM® and disposable plastic probe for Sonoclot®, (4) electromechanical signal transducer/signal detector (5) data processor
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4260302&req=5

Figure 4: Bio-mechanical working principles behind the three viscoelastic coagulation monitoring devices: (1) blood sample in rotating cup for TEG® and in cuvette for ROTEM® and Sonoclot®, (2) coagulation activator, (3) pin and torsion wire for TEG®, pin and rotating axis for ROTEM® and disposable plastic probe for Sonoclot®, (4) electromechanical signal transducer/signal detector (5) data processor

Mentions: The ROTEM® device uses a modification of the TEG® technology using 0.30 ml of blood. The TEG® uses kaolin as the contact activator whereas the ROTEM® incorporates tissue factor in the EXTEM® cuvette (clot formation and fibrinlolysis, extrinsic pathway) and contact activator in the INTEM® cuvette (intrinsic pathway)[22] [Figure 4]. Both devices permit coagulation monitoring under systemic heparinisation as in CPB, as they have heparinase containing cuvettes. This enables removal of the heparin effects on the tracing and helps identifying residual effects of heparin, as well as heparin rebound after protamine reversal.[22]


Coagulation testing in the perioperative period.

Thiruvenkatarajan V, Pruett A, Adhikary SD - Indian J Anaesth (2014)

Bio-mechanical working principles behind the three viscoelastic coagulation monitoring devices: (1) blood sample in rotating cup for TEG® and in cuvette for ROTEM® and Sonoclot®, (2) coagulation activator, (3) pin and torsion wire for TEG®, pin and rotating axis for ROTEM® and disposable plastic probe for Sonoclot®, (4) electromechanical signal transducer/signal detector (5) data processor
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260302&req=5

Figure 4: Bio-mechanical working principles behind the three viscoelastic coagulation monitoring devices: (1) blood sample in rotating cup for TEG® and in cuvette for ROTEM® and Sonoclot®, (2) coagulation activator, (3) pin and torsion wire for TEG®, pin and rotating axis for ROTEM® and disposable plastic probe for Sonoclot®, (4) electromechanical signal transducer/signal detector (5) data processor
Mentions: The ROTEM® device uses a modification of the TEG® technology using 0.30 ml of blood. The TEG® uses kaolin as the contact activator whereas the ROTEM® incorporates tissue factor in the EXTEM® cuvette (clot formation and fibrinlolysis, extrinsic pathway) and contact activator in the INTEM® cuvette (intrinsic pathway)[22] [Figure 4]. Both devices permit coagulation monitoring under systemic heparinisation as in CPB, as they have heparinase containing cuvettes. This enables removal of the heparin effects on the tracing and helps identifying residual effects of heparin, as well as heparin rebound after protamine reversal.[22]

Bottom Line: Perioperative coagulation management is a complex task that has a significant impact on the perioperative journey of patients.While the rapidly available bedside haemoglobin measurements can guide the transfusion of red blood cells, blood product administration is guided by many in vivo and in vitro tests.A proper understanding of the application and interpretation of the coagulation tests is vital for a good perioperative outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, South Australia ; Discipline of Acute Care Medicine, The University of Adelaide, South Australia.

ABSTRACT
Perioperative coagulation management is a complex task that has a significant impact on the perioperative journey of patients. Anaesthesia providers play a critical role in the decision-making on transfusion and/or haemostatic therapy in the surgical setting. Various tests are available in identifying coagulation abnormalities in the perioperative period. While the rapidly available bedside haemoglobin measurements can guide the transfusion of red blood cells, blood product administration is guided by many in vivo and in vitro tests. The introduction of newer anticoagulant medications and the implementation of the modified in vivo coagulation cascade have given a new dimension to the field of perioperative transfusion medicine. A proper understanding of the application and interpretation of the coagulation tests is vital for a good perioperative outcome.

No MeSH data available.


Related in: MedlinePlus