The influence of temperature adjustment on thromboelastography results: prospectíve cohort study



Year of publication 2011
Type Article in Periodical
Magazine / Source Anesteziologie a intenzivní medicína
MU Faculty or unit

Faculty of Medicine

Field Other medical specializations
Keywords thromboelastography; cardiopulmonary resuscitaction
Description Thromboelastography (TEG) and standard coagulation tests are carried out at a laboratory temperature of 37C, thus omitting the effects of reál blood temperature.The aim of this study was comparing the results of kaolin - heparinase TEG and Rapid TEG during mild therapeutic hypothermia i.e. when the blood was analysed at the actual temperature (isothermia) and at 37C (normothermia).The second aim was to evaluate the clinical relevance of the results and on their basis to determine the necessity to analyse TEG at the actual temperature. Thirty patients following CPR (cardiopulmonary resuscitation), where therapeutic hypothermia (32-34C) was indicated for 24 hours, were included in the study.The patients were observed for 36 hours, and the TEG measurements were taken in 12-hour intervals. Standard coagulation tests, blood count, the dose of anticoagulants/antiaggregants, bleeding complications and changes in treatment according to TEG results were monítored. Data is shown as median (IQR).The Wilcoxon match pair test was used for the statistical analysis was considered significant. In hypothermic kaolin-heparinase TEG, all parameters describing clot formation (R, K, Angle, TMA and ČI) were significantly different from those measured at 37C. Clot strength parameters (MA, G) did not differ. In Rapid TEG, the differences between hypothermia and normotermia were less pro-nounced. There were mostly minor signs of bleeding only and clinical judgement was not influenced by the difference in TEG measurements. Statistically significant differences in TEG results were more pronounced in kaolin-heparina-seTEG than in Rapid TEG. These differences were related just to clot formation. The laboratory changes had no impact on clinical judgement.

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