Viscoelastic hemostatic assays: Update on technology and clinical applications

Faraoni, David; DiNardo, James A.

doi:10.1002/ajh.26285

Cited by 20 publications

(9 citation statements)

References 31 publications

(54 reference statements)

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“…The ROTEM sigma’s refinement over earlier models is the use of a fully automated cartridge that reduces handling and errors in interpretation. [ 14 ]…”

Section: Recent Updates In the Perioperative Management Of Liver Tran...mentioning

confidence: 99%

Recent advances in anaesthesia for abdominal solid organ transplantation

et al. 2023

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Organ transplantation has undergone remarkable revolution in the last two decades and offers a scope for survival amongst patients with end-stage organ failure. Along with availability of advanced surgical equipment and haemodynamic monitors, minimally invasive surgical techniques have emerged as options for surgery both amongst the donors and recipients. Newer trends in haemodynamic monitoring and expertise in ultrasound guided fascial plane blocks have changed the management in both donors and recipients. The availability of factor concentrates and point-of-care tests for coagulation have allowed optimal and restrictive fluid management of patients. Newer immunosuppressive agents are useful in minimising rejection following transplantation. Concepts on enhanced recovery after surgery have allowed early extubation, feeding and shorter hospital stay. This review gives an overview of the recent progress in anaesthesia for organ transplantation.

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“…The ROTEM sigma’s refinement over earlier models is the use of a fully automated cartridge that reduces handling and errors in interpretation. [ 14 ]…”

Section: Recent Updates In the Perioperative Management Of Liver Tran...mentioning

confidence: 99%

Recent advances in anaesthesia for abdominal solid organ transplantation

et al. 2023

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“…In the updated version, ROTEM sigma, sample handling is automated. 21 Viscoelastic devices have varied regional regulatory approval status and may not be generally available. Where available, they are used in transfusion algorithms, cardiovascular surgery, trauma, liver transplant, and postpartum hemorrhage for optimal blood management.…”

Section: Viscoelastic Testingmentioning

confidence: 99%

The Use of Bypassing Treatment Strategies in Hemophilia and Their Effect on Laboratory Testing

Pruthi

Chen

2023

Semin Thromb Hemost

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Factor VIII and IX inhibitors in congenital hemophilia A and B, respectively, neutralize the infused coagulation factor concentrate rendering them ineffective. Bypassing agents (BPAs) that circumvent the block imposed by the inhibitors are used for the prevention and management of bleeding. Activated prothrombin complex concentrate was the original BPA, recombinant activated factor VII was then introduced, and more recently nonfactor agents that target the procoagulant and anticoagulant systems have been developed and are in clinical use (e.g., emicizumab, a bispecific antibody for hemophilia A). Other BPAs are in clinical trials (e.g., fitusiran targets antithrombin, concizumab and marstacimab target tissue factor pathway inhibitor, and SerpinPC targets activated protein C). The BPAs have a varied effect on coagulation assays, and as more patients are exposed to these agents, it is important to be aware of the effects. Herein, we present an overview of the effect of BPAs on routine and specialized coagulation assays including thrombin generation and viscoelastic assays.

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“…These tests take a significant amount of time for results and the clinical picture may change during this time. Viscoelastic hemostatic assays such as TEG, ROTEM, and most recently the sonorheometry‐based Quantra Hemostasis Analyzer (HemoSonics, Charlottesville, VA, USA), are effective in guiding perioperative blood management by reducing both the transfusion of allogeneic blood products and costs 13,15 …”

Section: Pre‐anhepatic Phasementioning

confidence: 99%

“…Viscoelastic hemostatic assays such as TEG, ROTEM, and most recently the sonorheometry-based Quantra Hemostasis Analyzer (HemoSonics, Charlottesville, VA, USA), are effective in guiding perioperative blood management by reducing both the transfusion of allogeneic blood products and costs. 13,15 As standardized protocols for transfusion in the pediatric liver transplant are not established, local clinical practice continues to prevail. Use fresh frozen plasma, cryoprecipitate, and platelets judiciously due to concerns for hepatic artery and portal vein thrombosis.…”

Section: Error Trap 22: Failure To Monitor For Coagulation Abnormalitiesmentioning

confidence: 99%

Educational Review: Error traps in anesthesia for pediatric liver transplantation

Ballard

Jones

Clemente

et al. 2022

Pediatric Anesthesia

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Nearly 60 years ago, the first liver transplant was attempted on a pediatric patient and within a few years, pediatric patients showed that extended survival after transplant was possible. 1 Despite decades of advancements in knowledge and skills improving long-term survival rates, the perioperative course continues to have a high potential for complications and iatrogenic adverse events. 2 There are varied indications for proceeding with pediatric liver transplantation which has been delineated. 3 The underlying cause necessitating the transplant determines what to anticipate with the procedure. These cases are prone to major fluid shifts, massive blood loss, rapid hemodynamic swings necessitating fluid resuscitation, blood products, and vasopressor support, while facing acute on chronic coagulation abnormalities, and imbalances in electrolyte and metabolic parameters. Patients with cirrhosis and resultant portal hypertension are at the most risk for these issues.Every organ system may be affected by end-stage liver disease, potentially resulting in encephalopathy, cerebral edema, hepatorenal syndrome, hepatopulmonary syndrome and pulmonary hypertension leading to increased peritransplant morbidity and mortality. Pediatric anesthesiologists deal with uncommon diseases of the liver and their

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Viscoelastic hemostatic assays: Update on technology and clinical applications

Cited by 20 publications

References 31 publications

Recent advances in anaesthesia for abdominal solid organ transplantation

Recent advances in anaesthesia for abdominal solid organ transplantation

The Use of Bypassing Treatment Strategies in Hemophilia and Their Effect on Laboratory Testing

Educational Review: Error traps in anesthesia for pediatric liver transplantation

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