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Related Experiment Videos

Point-of-Care Testing in Burn Patients.

Marion Wiegele1, Sibylle Kozek-Langenecker2, Eva Schaden1

  • 1Division of General Anaesthesia and Intensive Care Medicine, Department of Anaesthesia, Critical Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.

Seminars in Thrombosis and Hemostasis
|March 31, 2017
PubMed
Summary

Severe burn injuries affect blood clotting, with conventional tests suggesting bleeding issues. Viscoelastic tests reveal a hypercoagulable state, guiding better treatment for burn patients.

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Area of Science:

  • Trauma and Emergency Medicine
  • Hematology
  • Coagulation Science

Background:

  • Severe burn injury significantly impacts the coagulation system, yet a definitive classification of these changes remains elusive.
  • Conventional coagulation assays (CCAs) often indicate a coagulopathic state, suggesting a bleeding tendency in burn patients.
  • Viscoelastic coagulation assays (VCAs) like ROTEM and TEG present a contrasting view, indicating a hypercoagulable state.

Purpose of the Study:

  • To clarify the discrepancies in coagulation status assessment following severe burn injury.
  • To establish appropriate indications for hemostatic interventions based on reliable coagulation assessments.
  • To explore the utility of VCAs in managing massive blood loss and guiding thromboembolism prophylaxis.

Main Methods:

Related Experiment Videos

  • Comparison of results from conventional coagulation assays (CCAs) and viscoelastic coagulation assays (VCAs) in severe burn injury patients.
  • Analysis of the clinical implications of CCAs versus VCAs in guiding hemostatic interventions.
  • Evaluation of the potential role of VCAs in managing massive blood loss during surgical excision of burn wounds.
  • Assessment of VCA utility in individualizing pharmacologic venous thromboembolism prophylaxis.

Main Results:

  • Conventional coagulation assays may misinterpret the coagulation status, potentially leading to inappropriate hemostatic interventions.
  • Viscoelastic coagulation assays demonstrate a hypercoagulable state in severe burn injury patients.
  • VCAs are suggested as valuable tools for guiding targeted coagulation management, especially during massive blood loss.
  • Individualized venous thromboembolism prophylaxis, guided by sensitive laboratory tests, appears rational due to increased thromboembolic risk.

Conclusions:

  • Hemostatic interventions in severe burn injury should be guided by clinically relevant bleeding combined with indicative VCA results, not solely by deranged CCAs.
  • Viscoelastic coagulation assays show promise in guiding coagulation management and optimizing venous thromboembolism prophylaxis in burn patients.
  • Further research into new VCA test modifications is warranted to improve outcomes in this challenging patient population.