Viscoelastic hemostasis assays in septic, critically ill coronavirus disease 2019 patients: a practical guide for clinicians.
Viscoelastic hemostasis assays in septic, critically ill coronavirus disease 2019 patients: a practical guide for clinicians.
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DOI：
10.1097/mbc.0000000000000999
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发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Volod O
中科院分区：
文献类型：
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作者：
Gergi M;Goodwin A;Freeman K;Colovos C;Volod O
众所周知，冠状病毒病（COVID-19）与凝血功能障碍相关，其特征是DIC的血栓前状态不同于通常的脓毒症诱导的DIC，伴有明显的血管血栓形成和预后恶化。这种高凝性导致凝血酶生成和纤维蛋白形成增强。常规凝血试验，如凝血酶原时间和活化部分凝血活酶时间，并不总是积极反映这种状态。因此，血栓造影（TEG）似乎是评估COVID-19相关凝血病的潜在可靠方法。然而，TEG在败血症中的作用尚未明确。需要大型随机试验来确定TEG是否能够识别可能受益于败血症诱导凝血病抗凝治疗的患者。通过对TEG在脓毒症中应用的现有文献以及目前对COVID-19诱导凝血功能障碍的了解，我们为临床医生在COVID-19患者中进行TEG检测提供了实用指南。
It is well known that coronavirus disease (COVID-19) is associated with a coagulopathy characterized by a prothrombotic state of DIC different from the usual sepsis induced DIC with significant vascular thrombosis and worsening outcomes. This hypercoagulability results in enhanced thrombin generation and fibrin formation. Routine coagulation tests, such as the prothrombin time and the activated partial thromboplastin time, do not always actively reflect this state. Thrombelastography (TEG), appears therefore a potentially reliable method to evaluate COVID-19 related coagulopathy. TEG role in sepsis however has been less defined. Large randomized trials are needed to address whether TEG is able to identify patients likely to benefit from anticoagulation for sepsis induced coagulopathy. By reviewing the available literature on the use of TEG in sepsis, and the current knowledge on COVID-19 induced coagulopathy we provide clinicians with a practical guide on TEG testing in patients with COVID-19.