Thromboelastometry

Thromboelastometry is a method used in coagulation studies to assess the clotting process of blood. It is a test that measures the ability of blood to clot and subsequently dissolve the clot, providing a comprehensive picture of coagulation, fibrinolysis, and platelet function. Thromboelastometry is often used in surgery, trauma, obstetrics, and intensive care medicine to guide transfusion therapy and anticoagulant management.

History

The concept of thromboelastometry was first introduced in the 1940s by Dr. Helmut Hartert in Germany. He developed the first thromboelastograph, a device that measures the viscoelastic properties of blood during clotting. The technique has since been refined and is now widely used in clinical practice.

Method

Thromboelastometry involves the use of a small sample of blood, which is placed in a heated cup. The cup is then rotated slowly back and forth. As the blood begins to clot, the rotation of the cup is impeded, which is detected by a pin suspended in the blood sample. The movement of the pin is then translated into a graphical representation of the clotting process.

The test provides several parameters, including clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF), and lysis index (LI). These parameters provide information about the speed of clot formation, the stability of the clot, and the process of clot dissolution.

Clinical Applications

Thromboelastometry is used in various clinical settings to assess the coagulation status of patients. It is particularly useful in situations where rapid and comprehensive assessment of coagulation is required, such as in trauma, surgery, obstetrics, and intensive care.

In trauma patients, thromboelastometry can help guide the administration of blood products and anticoagulant therapy. It can also be used to monitor the effectiveness of treatment and predict the risk of bleeding or thrombosis.

In surgery, thromboelastometry is used to assess the risk of bleeding, guide transfusion therapy, and monitor the effects of anticoagulant drugs. It is particularly useful in major surgeries, such as cardiac surgery and liver transplantation, where the risk of bleeding is high.

In obstetrics, thromboelastometry can help assess the risk of postpartum hemorrhage and guide the management of coagulation disorders during pregnancy and childbirth.

In intensive care medicine, thromboelastometry is used to monitor coagulation status in critically ill patients, guide the administration of blood products, and assess the risk of thrombosis.

See Also

• Coagulation
• Trauma
• Surgery
• Obstetrics
• Intensive care medicine

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