Feasibility of using rotational thromboelastometry to assess coagulation status of combat casualties in a deployed setting

The Journal of Trauma
Catherine M DoranMark J Midwinter

Abstract

Coagulopathy in trauma patients is currently defined by the results of standard laboratory tests (prothrombin time and activated partial thromboplastin time). These results offer little in the hemostatic resuscitation that occurs in the treatment of battlefield patients who receive massive transfusions. Thromboelastometry (TEM) is a technique that can offer rapid, near-patient testing of coagulation status. A prospective observational field study was performed in a deployed military setting to determine the feasibility of using TEM to assess the coagulation status of patients admitted to the emergency department and who subsequently received a massive transfusion. TEM was performed on 31 patients, 25 were direct admissions to the emergency department, 19 of whom were enrolled into the massive transfusion protocol, and 60% were involved in a blast incident. Standard laboratory testing showed that 10% of all patients were coagulopathic on admission compared with 64% with an abnormal TEM trace (p = 0.0005). All patients had abnormal maximum clot firmness. The TEM amplitude at 10 minutes is associated with the subsequent development of abnormal maximum clot firmness. Two exemplar cases are discussed, which illustrate the potential ...Continue Reading

References

Apr 1, 1997·The Journal of Trauma·C R KaufmannA L Trask
Jun 19, 2003·The Journal of Trauma·Karim BrohiTimothy Coats
Jul 12, 2003·The Journal of Trauma·Jana B A MacLeodMary Murtha
May 26, 2004·Transfusion·John J ComoJohn R Hess
May 5, 2005·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Thomas LangMeret Lakner
Aug 17, 2005·Vox Sanguinis·P I JohanssonH Sørensen
Nov 17, 2006·British Journal of Haematology·UNKNOWN British Committee for Standards in HaematologyP J Hamilton
Nov 18, 2006·Journal of Thrombosis and Haemostasis : JTH·L RugeriC Negrier
Jan 12, 2007·Injury·Marc MaegeleUNKNOWN AG Polytrauma of the German Trauma Society (DGU)
Apr 7, 2007·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Vance G Nielsen
Jul 13, 2007·The Journal of Trauma·John B Holcomb
Mar 29, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Adam J SingerMark C Henry
Jun 12, 2008·The Journal of Trauma·Sarah E NilesJohn B Holcomb
Jul 16, 2008·Journal of the Royal Army Medical Corps·E KirkmanM Midwinter
Jan 16, 2009·Anaesthesia·G N B JacksonS M Yentis
Apr 11, 2009·The Journal of Trauma·Victor JegerAristomenis K Exadaktylos

❮ Previous
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Citations

Apr 17, 2013·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Luis Teodoro da LuzSandro Rizoli
Jan 7, 2014·Journal of the Royal Army Medical Corps·Simon MercerH E J Pugh
Feb 28, 2014·Journal of the Royal Army Medical Corps·Emrys Kirkman, S Watts
May 3, 2014·Journal of the Royal Army Medical Corps·Giles NordmannE Kirkman
Aug 28, 2014·The Journal of Trauma and Acute Care Surgery·David J O'ReillyMark J Midwinter
Jan 15, 2015·Current Anesthesiology Reports·Jeffrey W SimmonsBert Pierce
Dec 11, 2014·The Journal of Trauma and Acute Care Surgery·Luciana N TorresIvo Torres Filho
Nov 19, 2013·Current Opinion in Critical Care·Damian D KeeneTom Woolley
Jan 25, 2012·Current Opinion in Anaesthesiology·Daniel FrithKarim Brohi
May 10, 2013·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerPiet Wyffels
Oct 24, 2015·Emergency Medicine Journal : EMJ·J E SmithP A F Hunt
Aug 3, 2012·Revista española de anestesiología y reanimación·R Navarro SuayJ M Jiménez Vizuete
Aug 16, 2011·International Journal of Obstetric Anesthesia·Gary Stocks
Oct 25, 2011·British Journal of Haematology·Ross Davenport, Sirat Khan
Jun 8, 2012·Transfusion·Duncan MacIvorZaki-Udin Hassan
Jan 3, 2014·Journal of Veterinary Emergency and Critical Care·Lee Palmer, Linda Martin
Aug 3, 2016·Anaesthesia Critical Care & Pain Medicine·E FalzoneS Mérat
Mar 6, 2018·Military Medical Research·Zhao-Wen ZongUNKNOWN representing the PLA Professional Committee and Youth Committee on Disaster Medicine
Jan 4, 2013·The Journal of Trauma and Acute Care Surgery·Lorne H BlackbourneJohn B Holcomb
Dec 5, 2012·The Journal of Trauma and Acute Care Surgery·Nicholas T TarmeyMark J Midwinter
Feb 11, 2012·Journal of the Royal Army Medical Corps·E C AllcockI Mackenzie
Mar 3, 2020·The Journal of Trauma and Acute Care Surgery·Daniel T LammersMatthew J Eckert
Aug 13, 2015·Annals of the Royal College of Surgeons of England·G S ArulM J Midwinter
Jun 10, 2017·International Anesthesiology Clinics·Clinton P JonesGiles R Nordmann
Sep 7, 2018·Military Medicine·Andrew P CapZsolt Stockinger
Jun 12, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Pierre BouzatJean-Stéphane David
Apr 17, 2019·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Venencia AlbertSanjeev Kumar Bhoi
Jun 25, 2015·Current Reviews in Musculoskeletal Medicine·Wade GordonDavid Dromsky
Jul 5, 2018·Military Medical Research·Zhao-Wen ZongUNKNOWN Representing the Youth Committee on Traumatology branch of the Chinese Medical Association, the PLA Professional Committee a
Oct 1, 2020·Emergency Medicine Australasia : EMA·Don CampbellJames Winearls

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