Impact thromboelastometry (ITEM) for point-of-injury detection of trauma-induced coagulopathy: a pilot study

Trauma Surgery & Acute Care Open
Gerard S DoyleJ Nicholas Hansen

Abstract

Acute coagulopathy of trauma is associated with high mortality and extensive use of blood products. Hemostatic resuscitation, the early administration of blood products with higher ratios of procoagulant components, may improve trauma outcomes in select cases, but can also worsen outcome if inappropriately used. Evolving approaches to hemostatic resuscitation utilize viscoelastic tests to provide a more rational basis for choosing blood component therapy regimens, but these tests are logistically rigorous. We hypothesized that coagulopathy could be detected by the failure of blood clots to remain intact when subjected to a predefined impact force. We aim to develop a point-of-injury test for coagulopathy. We created coagulopathic blood using an ex vivo normal saline (NS) dilution model and allowed blood of varying dilutions to clot, then examined the behavior of the clotted blood when subjected to a uniform gravitationally induced sheer force. Clots created from coagulopatic blood (diluted to ≤50% with NS) failed under gravitational challenge at a significantly higher rate than non-coagulopathic blood dilutions. Impact thromboelastometry (ITEM) represents a simple, logistically lean method for detecting dilutional coagulopathy ...Continue Reading

References

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Citations

Jan 30, 2019·Current Opinion in Anaesthesiology·Corey Scher, Robert Mansky
Mar 1, 2019·Current Opinion in Anaesthesiology·Robert Mansky, Corey Scher

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Methods Mentioned

BETA
blood collection

Software Mentioned

ITEM
StataCorp
iStat
TEG
ROTEM

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