The Choice between Plasma-Based Common Coagulation Tests and Cell-Based Viscoelastic Tests in Monitoring Hemostatic Competence: Not an either–or Proposition

Connor M. Bunch; Margaret Berquist; Aida Ansari; Max L. McCoy; Jack H. Langford; Toby J. Brenner; Michael Aboukhaled; Samuel J. Thomas; Ethan Peck; Shivani Patel; Emily Cancel; Mahmoud D. Al-Fadhl; Nuha Zackariya; Anthony V. Thomas; John G. Aversa; Ryan B. Greene; Christopher W. Seder; Jacob Speybroeck; Joseph B. Miller; Hau C. Kwaan; Mark M. Walsh

doi:10.1055/s-0042-1756302

Seminars in Thrombosis and Hemostasis, Inhaltsverzeichnis

Semin Thromb Hemost 2022; 48(07): 769-784
DOI: 10.1055/s-0042-1756302

Review Article

The Choice between Plasma-Based Common Coagulation Tests and Cell-Based Viscoelastic Tests in Monitoring Hemostatic Competence: Not an either–or Proposition

Connor M. Bunch

¹Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan

,

Margaret Berquist

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Aida Ansari

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Max L. McCoy

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Jack H. Langford

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Toby J. Brenner

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Michael Aboukhaled

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Samuel J. Thomas

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Ethan Peck

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Shivani Patel

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Emily Cancel

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Mahmoud D. Al-Fadhl

³Indiana University School of Medicine, Notre Dame Campus, South Bend, Indiana

,

Nuha Zackariya

³Indiana University School of Medicine, Notre Dame Campus, South Bend, Indiana

,

Anthony V. Thomas

³Indiana University School of Medicine, Notre Dame Campus, South Bend, Indiana

,

John G. Aversa

⁴Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana

,

Ryan B. Greene

⁵Department of Interventional Radiology, St. Joseph Regional Medical Center, Mishawaka, Indiana

,

Christopher W. Seder

⁶Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois

,

Jacob Speybroeck

⁷Department of Orthopedic Surgery, Case Western Medical Center, Cleveland, Ohio

,

Joseph B. Miller

¹Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan

,

Hau C. Kwaan

⁸Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

,

Mark M. Walsh

²Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

³Indiana University School of Medicine, Notre Dame Campus, South Bend, Indiana

› Institutsangaben

Abstract

There has been a significant interest in the last decade in the use of viscoelastic tests (VETs) to determine the hemostatic competence of bleeding patients. Previously, common coagulation tests (CCTs) such as the prothrombin time (PT) and partial thromboplastin time (PTT) were used to assist in the guidance of blood component and hemostatic adjunctive therapy for these patients. However, the experience of decades of VET use in liver failure with transplantation, cardiac surgery, and trauma has now spread to obstetrical hemorrhage and congenital and acquired coagulopathies. Since CCTs measure only 5 to 10% of the lifespan of a clot, these assays have been found to be of limited use for acute surgical and medical conditions, whereby rapid results are required. However, there are medical indications for the PT/PTT that cannot be supplanted by VETs. Therefore, the choice of whether to use a CCT or a VET to guide blood component therapy or hemostatic adjunctive therapy may often require consideration of both methodologies. In this review, we provide examples of the relative indications for CCTs and VETs in monitoring hemostatic competence of bleeding patients.

Keywords

thromboelastography - hemorrhage - thrombosis - anticoagulants

Volltext

Referenzen

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