Thromboelastographic predictors of venous thromboembolic events in critically ill patients: are we missing something?

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
Fabiana TartamellaFilippo Testa

Abstract

Deep venous thromboembolism and pulmonary embolism are still underdiagnosed in the ICU. Thromboelastography (TEG) has shown considerable variability in sensitivity and specificity as a predictor of venous thromboembolism (VTE). We designed a prospective double-blind observational study to predict the risk of VTE using TEG in a cohort of critically ill patients. Seventy-two hours after admission in the ICU and consequent prophylaxis with low-molecular-weight heparin, we performed compressive color-Doppler ultrasound and diagnosed deep venous thrombosis. Computed tomography scan was performed for the diagnosis of pulmonary embolism if pulmonary embolism was suspected based on physical examination and transthoracic echocardiography. Whole blood samples were obtained from central venous lines 6-8 h after subcutaneous administration of low-molecular-weight heparin. Native TEG and modified heparinase TEG were performed using a Thromboelastograph Coagulation Analyzer. Fifty-seven patients were consecutively enrolled of which six (10.5%) developed deep venous thrombosis; two (3.5%) also developed pulmonary embolism. The native thrombodynamic ratio (TDR) was an independent predictor of the odds of thrombosis (odds ratio 1.016, P < 0.05,...Continue Reading

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Citations

Jul 12, 2018·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Erin K I MurrayMaha Othman
Nov 8, 2017·European Journal of Haematology·Yusrah Harahsheh, Kwok M Ho
May 25, 2018·Scandinavian Journal of Clinical and Laboratory Investigation·Caroline U NilssonPeter Reinstrup
Apr 28, 2021·International Journal of Obstetric Anesthesia·J H Waters, M P Bonnet

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