Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures.
Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures.
复制标题
骨科创伤和择期手术的粘弹性止血分析。
DOI：
10.3390/jcm11144029
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发表时间：
2022-07-12
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
粘弹性止血试验（VHAs）（例如，血栓弹性成像（TEG）和旋转血栓弹性测量（ROTEM））在骨科中的应用与其他外科领域相比处于相对初级阶段。幸运的是，最近的一些研究描述了vha在骨科创伤和择期骨科手术中快速可靠地实时分析凝血和纤溶状态的新应用。创伤性凝血功能障碍——一系列凝血表型异常，包括凝血因子耗竭、凝血酶生成不足、血小板功能障碍和纤维蛋白溶解失调——仍然是严重损伤和/或出血患者的潜在致命并发症，使用vha有助于及时诊断和治疗。此外，vha是对普通凝血试验的宝贵补充，有助于检测通常与骨科损伤和术后状态相关的高凝状态。使用vha来识别高凝性允许准确的静脉血栓栓塞（VTE）风险评估和监测VTE预防。到目前为止，有关静脉血栓形成预防的剂量和持续时间方面的数据还不够充分。通过将vha纳入常规实践，骨科医生将更好地诊断和治疗骨科患者所面临的各种凝血异常。这项工作作为一个教育入门和最新的评论，目前的文献在骨科手术中使用vha。
The application of viscoelastic hemostatic assays (VHAs) (e.g., thromboelastography (TEG) and rotational thromboelastometry (ROTEM)) in orthopedics is in its relative infancy when compared with other surgical fields. Fortunately, several recent studies describe the emerging use of VHAs to quickly and reliably analyze the real-time coagulation and fibrinolytic status in both orthopedic trauma and elective orthopedic surgery. Trauma-induced coagulopathy—a spectrum of abnormal coagulation phenotypes including clotting factor depletion, inadequate thrombin generation, platelet dysfunction, and dysregulated fibrinolysis—remains a potentially fatal complication in severely injured and/or hemorrhaging patients whose timely diagnosis and management are aided by the use of VHAs. Furthermore, VHAs are an invaluable compliment to common coagulation tests by facilitating the detection of hypercoagulable states commonly associated with orthopedic injury and postoperative status. The use of VHAs to identify hypercoagulability allows for an accurate venous thromboembolism (VTE) risk assessment and monitoring of VTE prophylaxis. Until now, the data have been insufficient to permit an individualized approach with regard to dosing and duration for VTE thromboprophylaxis. By incorporating VHAs into routine practice, orthopedic surgeons will be better equipped to diagnose and treat the complete spectrum of coagulation abnormalities faced by orthopedic patients. This work serves as an educational primer and up-to-date review of the current literature on the use of VHAs in orthopedic surgery.
DOI：
10.1007/s00068-020-01533-8
发表时间：
2022-03
期刊：
European journal of trauma and emergency surgery : official publication of the European Trauma Society
影响因子：
--
作者：
Bostian PA;Ray JJ;Karolcik BA;Bramer MA;Wilson A;Dietz MJ
通讯作者：
Dietz MJ
DOI：
10.1590/s0100-879x2012007500095
发表时间：
2012-09
期刊：
Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
影响因子：
--
作者：
Topçu I;Civi M;Oztürk T;Keleş GT;Coban S;Yentür EA;Okçu G
通讯作者：
Okçu G
影响因子：
1.9
作者：
Lloyd-Donald P;Lee WS;Liu GM;Bellomo R;McNicol L;Weinberg L
通讯作者：
Weinberg L