A Reduction in Clot Formation Rate and Strength Assessed by Thrombelastography Is Indicative of Transfusion Requirements in Patients With Penetrating Injuries

• DOI: 10.1097/ta.0b013e318160772d
• Publication Date: 2008-02-04T08:05:18Z
• Authors: Amy J. Plotkin; Charles E. Wade; Donald H. Jenkins; Kimberly A. Smith; Jody C. Noe; Myung S. Park; Jeremy G. Perkins; John B. Holcomb
• Keywords: Thrombelastography; Prothrombin time; Blood product; Thromboelastography; Thrombin time

Background: Bleeding is a major cause of death in patients with traumatic injuries. Recently, thrombelastograph (TEG) has been suggested as an additional means evaluating coagulation trauma patients. We hypothesized that TEG data would aid defining the coagulopathy penetrating Methods: A retrospective study was performed (n = 44) injuries admitted to combat support hospital during 2-month period 2004. Recorded included standard laboratory data, parameters, and blood product use first 24 hours after admission. Values were compared clinically accepted ranges those obtained from Haemoscope Corporation. Results: At admission, International Normalization Ratio, prothrombin time, partial thromboplastin time increased 39% (≥1.5), 31% (>16 seconds), 37% (>40 seconds) patients, respectively, suggesting hypocoagulation, but these variables did not correlate products (p > 0.05). values within admission (6 ± 5.7 hours; median 4.5 hours) demonstrated hypocoagulation based on delayed propagation clot (increased K reduced α-angle) decreased strength (reduced maximal amplitude [MA]). MA correlated (r 0.57, p < 0.01) well platelet count 0.61, 0.01). Patients 23) used more had counts hematocrit. Conclusion: Thrombelastography accurate indicator requirements our patient population than Ratio. enhanced by hematocrit can guide transfusion requirements.