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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
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Comparison of standard coagulation testing with thromboelastometry tests in cardiac surgery
Elham Khalaf-Adeli1, Mostafa Alavi2, Alireza Alizadeh-Ghavidel3
1Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
Journal of Cardiovascular and Thoracic Research
|December 12, 2019
Summary
Thromboelastometry (TEM) offers a more comprehensive assessment of coagulation than standard tests during cardiac surgery. TEM provides faster, more accurate results for managing bleeding and reducing unnecessary blood transfusions.
Area of Science:
- Cardiovascular Surgery
- Hemostasis and Thrombosis
- Point-of-Care Testing
Background:
- Thromboelastometry (TEM) is a point-of-care test shown to reduce blood loss and transfusion needs in cardiac surgery.
- Limited comparative data exists between TEM and standard coagulation tests (SCTs) in this setting.
Purpose of the Study:
- To compare the diagnostic performance of TEM versus SCTs (prothrombin time, activated partial thromboplastin time, fibrinogen) in patients undergoing combined coronary-valve surgery.
Main Methods:
- Forty adult patients undergoing on-pump combined coronary-valve surgery were enrolled.
- Blood samples were collected pre- and post-cardiopulmonary bypass (CPB).
- TEM parameters (Fibtem, Intem, Extem, Heptem) and SCTs (PT, PTT, fibrinogen) were analyzed simultaneously.
Main Results:
- No significant correlation was found between PT/PTT and TEM parameters (CT-Extem, CT-Intem) pre- or post-CPB.
- Fibrinogen levels showed a strong correlation with TEM parameters (A10-Fibtem, A10-Extem) pre-CPB.
- A high percentage of SCTs were outside reference ranges (PT: 82%, PTT: 84%), while abnormal TEM results (CT-Extem, CT-Intem) were less frequent (17.9%).
Conclusions:
- Standard coagulation tests are time-consuming and may not accurately reflect the overall hemostatic status during cardiac surgery.
- TEM provides a more comprehensive and rapid assessment of coagulation compared to SCTs.
- Relying solely on SCTs can lead to inappropriate blood transfusions; TEM may improve perioperative hemostatic management.
