The role of thromboelastometry in the assessment and treatment of coagulopathy in liver transplant patients
The role of thromboelastometry in the assessment and treatment of coagulopathy in liver transplant patients
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DOI：
10.1590/s1679-45082017md3903
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发表时间：
2017-06-01
期刊：
影响因子：
--
通讯作者：
Serpa Neto, Ary
中科院分区：
文献类型：
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作者：
Zamper, Raffael Pereira Cezar;Amorim, Thiago Chaves;Serpa Neto, Ary
围手术期凝血监测对于评估出血风险、诊断与出血相关的缺陷以及指导重大外科手术（如肝移植）中的止血治疗至关重要。常规静态测试需要较长的周转时间，并且不能评估血小板功能;它们是在37摄氏度的标准温度下对血浆进行测定的;因此这些测试不适合术中使用。相比之下，评估全血粘弹性的方法，如血栓弹性图和旋转血栓弹性测定法，可提供快速定性凝血评估和适当的输血治疗指导。这些都是有前途的工具，用于评估和治疗高凝和低凝状态与出血的肝移植。当与传统的测试和客观评估的手术领域相结合，这些信息提供了理想的指导输血策略，与潜在的改善患者的结果。
Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37 degrees C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy. These are promising tools for the assessment and treatment of hyper-and hypocoagulable states associated with bleeding in liver transplantation. When combined with traditional tests and objective assessment of the surgical field, this information provides ideal guidance for transfusion strategies, with potential improvement of patient outcomes.