Tailoring haemostatic treatment to patient requirements - an update on monitoring haemostatic response using thrombelastography.

摘要: Currently, there is no single haemostasis laboratory test that has the capacity to accurately illustrate clinical effects of procoagulant or anticoagulant interventions. Although time course thrombin generation in plasma and endogenous potential (ETP) may be useful coagulation parameters, clotting involves components other than (e.g. platelets, fibrinogen). The continuous profiles thrombelastography provide a more accurate reflection vivo biology, covering initiation, development final clot strength during whole blood formation. This method helped clarify mechanism action formation, demonstrating differences from plasma, importance platelets tissue factor titrations. It also been used investigate hypocoagulation (in haemophilia A, rare disorders, therapy dilutional coagulopathy), hypercoagulation ex testing haemostatic Thrombelastography shown reflect efficacy activated prothrombin complex concentrate (aPCC) recombinant VII (rFVIIa) patients with A inhibitors acquired haemophilia. Overall, tailoring assays correlate phenotypes essential for effective monitoring. Applying an algorithm preoperative, perioperative postoperative tests, including thrombelastography, enable physicians achieve this.