Whole blood coagulation thrombelastographic profiles employing minimal tissue factor activation

Sørensen, Benny; Johansen, Peter; Christiansen, Karl O.; Woelke, M; Ingerslev, Jørgen

doi:10.1046/j.1538-7836.2003.00075.x

Cited by 335 publications

(349 citation statements)

References 24 publications

(23 reference statements)

Supporting

Mentioning

338

Contrasting

Unclassified

Order By: Relevance

“…GmbH, Munich, Germany) consistent with our method described elsewhere [8]. In brief, the citrated WB rested for 30 minutes at ambient temperature.…”

Section: Thromboelastometry Whole Blood Coagulation Analysismentioning

confidence: 99%

“…During the past decade, renewed interest has arisen in the use of thromboelastography or thromboelastometry for evaluation of coagulation kinetics [1][2][3][4][5][6][7][8][9][10][11][12]. These viscoelastic analyses benefit by providing a continuous visualization of physical changes occurring during blood coagulation.…”

Section: Introductionmentioning

confidence: 99%

“…and maximum clot firmness with new dynamic parameters such as maximum velocity of clot formation and the time to maximum velocity of clot formation [8,13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

et al. 2010

View full text Add to dashboard Cite

Introduction: Renewed interest has arisen in the use of thromboelastography/thromboelastometry in evaluating coagulation kinetics. The test medium, type of activator and its concentration may influence the interpretation of coagulation kinetics. This study aimed to investigate methodological influences of activator and test medium on thromboelastometric parameters of coagulation kinetics. Methods: Dynamic clot formation was evaluated by thromboelastometry using whole blood (WB), platelet rich plasma or platelet poor plasma employing different concentrations of extrinsic (tissue factor) and contact activator (synthasil) and with variable concentrations of phospholipids. Results: Plasma samples displayed prolonged clot initiation and enhanced clot propagation compared to WB. Clot firmness was markedly reduced in platelet poor plasma as compared to platelet rich plasma and whole blood. Increasing concentration of activator shortened the clot initiation and increased the velocity of clot propagation whereas terminal clot firmness remained unaffected. Platelets accelerated clot propagation and raised clot firmness. Phospholipids shortened the time of clot initiation and increased velocity of propagation, while clot firmness remained unchanged. Conclusion: Our results demonstrate that evaluation of coagulation kinetics using thromboelastometry vary according to the composition of the test medium, type-and concentration of activator, as well as the presence and concentration of phospholipids in the test reagent.Response to Reviewers: Response to reviewers.First and foremost, thank you very much for the positive and constructive review. We have tried our best to answer all questions and revised the manuscript accordingly.Reviewer #1: This is a nice methodological paper about the ROTEM device, which is well written by an experienced group.Minor comments 1) P3 , line 41: physiologically -corrected 2) P4, line 28: significantly -corrected 3) Please indicate molar concentrations of synthasil and Innovin, if possible Unfortunately, it is not possible to use molar concentrations. We are working on a detailed (including molar concentrations and activity) examination of various tissue factor sources, however that reached beyond the scope of the present study. 4) P9: followed -corrected 5) P11, line 38: please add . "in vitro [33] as well as coagulation activation in vivo, when the blood is only re-calcified [PMID: 16420574]" Thank you for this excellent point, we have added accordingly. 6) I am not sure whether I could reproduce the phospholipid preparation, maybe a graphical scheme could be helpfulWe have slightly rephrased 7) As many users of the ROTEM probably will not have the extra software, please consider providing graphical presentations of the CT and /or alpha angle in addition to MaxVel, which is a derived variable CT has been included. We found it too excessive to also show alpha. 8) Refs 21 and 26 appear identical to meWe have corrected the reference list accordingly Reviewer #2: The paper by Sorensen et ...

show abstract

“…GmbH, Munich, Germany) consistent with our method described elsewhere [8]. In brief, the citrated WB rested for 30 minutes at ambient temperature.…”

Section: Thromboelastometry Whole Blood Coagulation Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

et al. 2010

View full text Add to dashboard Cite

show abstract

“…9 To study effects of rFVIIa, blood samples need to be activated with minute amounts of tissue factor for best sensitivity. 10,11 Presence of high amounts of tissue factor may directly activate the coagulation cascade (bypassing agent) and effects of rFVIIa may no longer be monitored. 11 Modern practice of coagulation management is based on rapid diagnosis of the patient's coagulation status, specific component therapy, and monitoring of the procoagulant treatment.…”

Section: Introductionmentioning

confidence: 99%

Monitoring Recombinant Factor VIIa Treatment: Efficacy Depends on High Levels of Fibrinogen in a Model of Severe Dilutional Coagulopathy

Ganter

Schmuck

Hamiel

et al. 2008

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

“…Consensus guidelines have been published for these off-label indications, but it is still unclear how to reliably monitor patients receiving rVIIa [39]. To better study the result of thrombin generation, modified TEG/ROTEM parameters based on the first derivative of original TEG/ROTEM tracing have been introduced recently: maximum velocity of clot formation (MaxVel), time to reach MaxVel (tMaxVel), and total thrombus generation (area under the curve) [40,41]. These parameters may be more sensitive to rVIIa than standard TEG/ROTEM parameters [42].…”

Section: Monitoring Procoagulationmentioning

confidence: 99%

Perioperative coagulopathy monitoring

et al. 2013

View full text Add to dashboard Cite

Coagulopathy is common in orthopedic surgery patients either due to acquired factors, such as surgery, trauma, medications, or hemorrhage. Perioperative monitoring of blood coagulation is critical to diagnose the causes of hemorrhage, guide hemostatic therapies, predict the risk of bleeding during surgical procedures, and reduce risk of postoperative cardiac and thromboembolic events. In contrast to previous interventions that measure specific portions of the clotting cascade (such as intrinsic or extrinsic pathways or platelet aggregation), ''Point-ofcare'' coagulation monitoring devices assess the viscoelastic properties of whole blood. These techniques have the potential to measure the entire clotting process, starting with fibrin formation, clot retraction, and fibrinolysis. Furthermore, the coagulation status of patients is assessed in whole blood, allowing the plasmatic coagulation system to interact with platelets and red cells, and thereby providing useful additional information on platelet function. Improved monitoring of coagulopathy is particularly important as new anticoagulant drugs emerge that affect the clotting cascade in novel ways, including the inhibition of intrinsic and extrinsic pathways and platelet function. It is important for orthopedic surgeons to understand the pharmacology and reversal of these drugs in the perioperative setting. The purpose of this review is to review the current techniques to monitoring perioperative coagulopathy and to identify the manner in which novel anticoagulant medications affect the clotting cascade with particular interest in trauma and spine surgery.

show abstract

Whole blood coagulation thrombelastographic profiles employing minimal tissue factor activation

Cited by 335 publications

References 24 publications

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

Evaluation of coagulation kinetics using thromboelastometry—methodologic influence of activator and test medium

Monitoring Recombinant Factor VIIa Treatment: Efficacy Depends on High Levels of Fibrinogen in a Model of Severe Dilutional Coagulopathy

Perioperative coagulopathy monitoring

Contact Info

Product

Resources

About