Heparin induced thrombocytopenia diagnosis in cardiac surgery: is there a role for thromboelastography?

Kouerinis, Ilias A.; Kourtesis, Antonios; El-Ali, M.; Sergentanis, Theodoros N.; Plagou, Athena; Argiriou, Mihalis; Theakos, Nikolaos; Giannakopoulou, Anastasia

doi:10.1510/icvts.2007.161679

Cited by 10 publications

(4 citation statements)

References 7 publications

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“…Thromboelastograph (TEG) is a point-of-care test for evaluation of hemostasis, which has been widely used in the field of liver transplantation and coronary bypass surgery as an intraoperative hemostatic monitoring device [[5]– [7]]. By measuring the dynamic process of blood coagulation, with defined parameters reflecting integrity of specific hemostatic components, this device can differentiate hypercoagulable state into different types—platelet, enzymatic, and mixed, according to the manufacturer [[8]].…”

Section: Introductionmentioning

confidence: 99%

Changes of thrombelastography in patients undergoing elective primary total knee and total hip replacement with low molecular heparin prophylaxis

et al. 2014

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BackgroundThere has been no effective method to monitor the changes of blood coagulation after thromboprophylaxis for elective arthroplasty patients. The objective of this study is to assess the coagulation status of patients undergoing arthroplasty with thromboelastograph (TEG).MethodsNinety patients undergoing primary elective unilateral arthroplasty were investigated. Thromboprophylaxis continued for at least 10 days. TEG was performed on the day before the operation and on postoperative days 1, 4, and 9.ResultsThe total hip and total knee groups showed significant changes in the distribution of different hypercoagulable states on days 1–4 and on days 4–9. On day 9 after operation, 34 out of 90 (37.8%) of the total hip and total knee patients were found with hypercoagulable state. Of these 34 patients with hypercoagulable state, 26 (76.5%) demonstrated platelet or mixed hypercoagulability.ConclusionsThrombelastography was an effective way to identify hypercoagulability in patients undergoing elective primary total knee and total hip replacement. Platelet may play an important role in the progress of blood hypercoagulability.

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Section: Introductionmentioning

confidence: 99%

Changes of thrombelastography in patients undergoing elective primary total knee and total hip replacement with low molecular heparin prophylaxis

et al. 2014

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“…This pathological feature suggests that patients with thrombotic microangiopathy are intrinsically prothrombotic. If this is the case, it may be possible to use viscoelastic point-of-care devices such as TEG® to confirm the associated hypercoagulability with a reduced r-time or increased maximum amplitude (MA), similar to patients with trauma, sepsis, or heparin-induced thrombocytopenia syndrome [2][3][4] .…”

Section: Thromboelastometry and Thromboelastography Failed To Detect mentioning

confidence: 99%

Correspondence

Harahsheh¹,

Ho²

2016

Anaesth Intensive Care

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“…TEG may be useful in identifying patients that develop heparin-induced thrombocytopenia (HIT) after cardiac surgery (1-3% of patients) [Warkentin and Greinacher, 2003], in order to guide early treatment and decrease mortality [Kouerinis et al, 2007]. A study is currently being conducted to assess the role of TEG in determining the risk of bleeding or thromboembolic complications in a group of patients diagnosed to have HIT postcardiac surgery [Kouerinis et al, 2008].…”

Section: Teg and Perioperative Thrombosismentioning

confidence: 99%

Role of Thrombelastography (TEG) in Risk Assessment and Guidance of Antithrombotic Therapy in Patients with Coronary Artery Disease

Bitar

Kreutz

2013

Drug Development Research

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Thrombelastography (TEG) is a viscoelastic assay method used to assess whole blood and plasma coagulation kinetics. Specialized platelet mapping assays have been developed for the TEG platform to quantify the extent of platelet inhibition derived from P2Y12 receptor inhibitors, glycoprotein IIb/IIIa inhibitors, and aspirin. In this review, we describe the current evidence and summarize the data supporting the use of TEG in patients with cardiovascular disease. High thrombin-or adenosine diphosphate (ADP)-induced whole blood maximal clot strength (MA) has been associated with increased risk of ischemic events after percutaneous coronary interventions (PCI) and coronary artery bypass grafting (CABG). We discuss the data linking an increased clot strength phenotype with changes in metabolic and inflammatory markers. In addition, the data supporting the role of TEG in identifying subjects at risk for hemorrhagic complications while treated with dual antiplatelet therapy or while undergoing cardiac surgery is reviewed. In summary, TEG may provide additional information combining coagulation and platelet measurements within one assay, as compared with traditional coagulation or platelet assays. Further research is warranted to establish the role of TEG in personalized medicine treatment protocols. Drug Dev Res 74 : 533-540, 2013.

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Heparin induced thrombocytopenia diagnosis in cardiac surgery: is there a role for thromboelastography?

Cited by 10 publications

References 7 publications

Changes of thrombelastography in patients undergoing elective primary total knee and total hip replacement with low molecular heparin prophylaxis

Changes of thrombelastography in patients undergoing elective primary total knee and total hip replacement with low molecular heparin prophylaxis

Correspondence

Role of Thrombelastography (TEG) in Risk Assessment and Guidance of Antithrombotic Therapy in Patients with Coronary Artery Disease

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