covid
Buscar en
Revista Colombiana de Anestesiología
Toda la web
Inicio Revista Colombiana de Anestesiología Tromboelastografía: evaluación global de la coagulación. Aplicaciones en el p...
Información de la revista
Vol. 39. Núm. 3.
Páginas 410-423 (agosto - octubre 2011)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 39. Núm. 3.
Páginas 410-423 (agosto - octubre 2011)
REPORTE DE CASO
Open Access
Tromboelastografía: evaluación global de la coagulación. Aplicaciones en el periodo perioperatorio
Thromboelastography
Visitas
13751
Fritz E. Gempeler R.
,
Autor para correspondencia
gempeler@javeriana.edu.co

Calle 83 No. 9–86 Apto 501 Bogotá, Colombia.
, Ana Helena Perea B.**, Lorena Díaz B.***
* Profesor Asociado Facultad de Medicina Pontificia Universidad Javeriana. Anestesiólogo Hospital Universitario San Ignacio (HUSI). Bogotá Colombia.
** Instructora, Facultad de Medicina, Pontificia Universidad Javeriana. Anestesióloga, Hospital Universitario de San Ignacio, Bogotá, Colombia.
*** Anestesióloga, Hospital Universitario de San Ignacio. Bogotá, Colombia.
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
RESUMEN

La tromboelastografía es un método diagnostico de uso relativamente reciente, enfocado a evaluar de forma global la coagulación. Este método ha evolucionado con rapidez hacia el uso frecuente en la clínica, y es de utilidad para la evaluación de coagulopatías y como guía para la intervención; además, se ha encontrado que su implementación rutinaria conlleva la disminución en el uso de transfusión de hemoderivados y, consecuentemente, en los costos y complicaciones asociadas a su administración. Este reporte de casos en pacientes del Hospital Universitario de San Ignacio describe situaciones clínicas alternas a las de uso común, en las cuales el uso de la tromboelastografía aporta un excelente complemento diagnóstico y guía terapéutica en el perioperatorio.

Palabras clave::
Tromboelastografía
coagulación sanguínea
periodo perioperatorio
diagnóstico. (Fuente: DeCS, BIREME).
SUMMARY

Thromboelastography is a relatively new diagnostic method designed for a global evaluation of coagulation. This method has rapidly evolved and is frequently used in the clinic for the evaluation of coagulopathies and as guide for intervention; furthermore, its routine application on a daily basis reduces the need for transfusion of hemoderivatives, and consequently lessens the costs and complications thereof. This case report of patients from the San Ignacio University Hospital, describes infrequent clinical situations in which the use of thromboelastography provides an excellent diagnostic aid and treatment guide during the perioperative period.

Key Words:
Thrombelastography
blood coagulation
perioperative period
diagnosis. (Source: MeSH, NLM).
El Texto completo está disponible en PDF
REFERENCES
[1.]
P. Di Benedetto, M. Baciarello, L. Cabetti.
Thrombelastography. Present and future perspectives in clinical practice.
Minerva Anestesiol, 69 (2003), pp. 501-509
[2.]
H. Reikvam, E. Steien, B. Hauge.
Thrombelastography.
Transfus Apher Sci., 40 (2009), pp. 119-123
[3.]
K. Ak, C.S. Isbir, S. Tetik.
Thromboelastographybased transfusion algorithm reduces blood product use after elective CABG: a prospective randomized study.
J Card Surg., 24 (2009), pp. 404-410
[4.]
M. Wasowicz, S.A. McCluskey, D.N. Wijeysundera.
The incremental value of thrombelastography for prediction of excessive blood loss after cardiac surgery: an observational study.
Anesth Analg., 111 (2010), pp. 331-338
[5.]
American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies.
Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies.
Anesthesiology, 105 (2006), pp. 198-208
[6.]
R.J. Luddington.
Thrombelastography/thromboelastometry.
Clin Lab Haematol., 27 (2005), pp. 81-90
[7.]
Y. Dai, A. Lee, L.A. Critchley.
Does thromboelastography predict postoperative thromboembolic events? A systematic review of the literature.
Anesth Analg., 108 (2009), pp. 734-742
[8.]
M.S. Park, W.Z. Martini, M.A. Dubick.
Thromboelastography as a better indicator of hypercoagulable state after injury than prothrombin time or activated partial thromboplastin time.
[9.]
A. Chen, J. Teruya.
Global hemostasis testing thromboelastography: old technology, new applications.
Clin Lab Med., 29 (2009), pp. 391-407
[10.]
M.A. Schreiber, J. Differding, P. Thorborg.
Hypercoagulability is most prevalent early after injury and in female patients.
J Trauma, 58 (2005), pp. 475
[11.]
P. Sharma, R. Saxena.
A novel thromboelastographic score to identify overt disseminated intravascular coagulation resulting in a hypocoagulable state.
Am J Clin Pathol., 134 (2010), pp. 97-102
[12.]
D. Wilson, D.A. Cooke, M.A. McNally.
Changes in coagulability as measured by thrombelastography following surgery for proximal femoral fracture.
Injury., 32 (2001), pp. 765-770
[13.]
D.J. McCrath, E. Cerboni, R.J. Frumento.
Thromboelastography maximum amplitude predicts postoperative thrombotic complications including myocardial infarction.
Anesth Analg., 100 (2005), pp. 1576-1583
[14.]
P. Zufferey, F. Merquiol, S. Laporte.
Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery?.
Anesthesiology., 105 (2006), pp. 1034-1046
[15.]
G. Benoni, H. Fredin, R. Knebel.
Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations.
Acta Orthop Scand., 72 (2001), pp. 442-448
[16.]
B.E. Ickx, P.J. van der Linden, C. Melot.
Comparison of the effects of aprotinin and tranexamic acid on blood loss and red blood cell transfusion requirements during the late stages of liver transplantation.
Transfusion., 46 (2006), pp. 595-605
[17.]
M.J. Gallimore, S.L. Harris, K.A. Tappenden.
Urokinase induced fibrinolysis in thromboelastography: a model for studying fibrinolysis and coagulation in whole blood.
J Thromb Haemost., 3 (2005), pp. 2506-2513
[18.]
K. Zmuda, D. Neofotistos, C.H. Ts'ao.
Effects of unfractionated heparin, low-molecular-weight heparin, and heparinoid on thromboelastographic assay of blood coagulation.
Am J Clin Pathol, 113 (2000), pp. 725-731
[19.]
J.A. Coppell, U. Thalheimer, A. Zambruni.
The effects of unfractionated heparin, low molecular weight heparin and danaparoid on the thromboelastogram (TEG): an in-vitro comparison of standard and heparinase-modified TEGs with conventional coagulation assays.
Blood Coagul Fibrinolysis., 17 (2006), pp. 97-104
[20.]
R. Simons, S.V. Mallett.
Use of thromboelastography to demonstrate persistent anticoagulation after stopping enoxaparin.
Anaesthesia., 62 (2007), pp. 1175-1178
[21.]
P.Y. Van, S.D. Cho, S.J. Underwood.
Thrombelastography versus AntiFactor Xa levels in the assessment of prophylactic-dose enoxaparin in critically ill patients.
[22.]
S.M. Klein, T.F. Slaughter, P.T. Vail.
Thromboelastography as a perioperative measure of anticoagulation resulting from low molecular weight heparin: a comparison with anti-Xa concentrations.
Anesth Analg., 91 (2000), pp. 1091-1095
[23.]
H.N. Modi, S.W. Suh, J.Y. Hong.
Intraoperative blood loss during different stages of scoliosis surgery: A prospective study.
Scoliosis., 5 (2010), pp. 16
[24.]
A. Coppola, G. Di Minno.
Desmopressin in inherited disorders of platelet function.
Haemophilia., 14 (2008), pp. 31-39
[25.]
M.C. Theroux, D.H. Corddry, A.E. Tietz.
A study of desmopressin and blood loss during spinal fusion for neuromuscular scoliosis: a randomized, controlled, double-blinded study.
Anesthesiology., 87 (1997), pp. 260-267
[26.]
W. Stevens, H. Koene, J.J. Zwaginga.
Chronic idiopathic thrombocytopenic purpura: present strategy, guidelines and new insights.
Neth J Med., 64 (2006), pp. 356-363
[27.]
K.E. Webert, R. Mittal, C. Sigouin.
A retrospective 11-year analysis of obstetric patients with idiopathic thrombocytopenic purpura.
Blood., 102 (2003), pp. 4306-4311
Copyright © 2011. Revista Colombiana de Anestesiología
Opciones de artículo