Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury.

Autor: Bradbury JL; Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA., Thomas SG; Department of Trauma Surgery, Memorial Hospital, South Bend, IN 46601, USA., Sorg NR; Department of Emergency Medicine, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA., Mjaess N; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Berquist MR; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Brenner TJ; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Langford JH; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Marsee MK; Department of Otolaryngology, Portsmouth Naval Medical Center, Portsmouth, VA 23708, USA., Moody AN; Department of Emergency Medicine, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA., Bunch CM; Department of Emergency Medicine, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA., Sing SR; Department of Emergency Medicine, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA., Al-Fadhl MD; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Salamah Q; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Saleh T; Department of Intensive Care Medicine, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Patel NB; Department of Neurosurgery, Memorial Hospital, South Bend, IN 46601, USA.; Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Shaikh KA; Department of Neurosurgery, Memorial Hospital, South Bend, IN 46601, USA.; Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Smith SM; Department of Neurosurgery, Memorial Hospital, South Bend, IN 46601, USA.; Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Langheinrich WS; Department of Neurosurgery, Memorial Hospital, South Bend, IN 46601, USA.; Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Fulkerson DH; Department of Neurosurgery, Memorial Hospital, South Bend, IN 46601, USA.; Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN 46545, USA., Sixta S; Department of Trauma Surgery, Envision Physician Services, Plano, TX 75093, USA.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2021 Oct 28; Vol. 10 (21). Date of Electronic Publication: 2021 Oct 28.
DOI: 10.3390/jcm10215039
Abstrakt: A unique coagulopathy often manifests following traumatic brain injury, leading the clinician down a difficult decision path on appropriate prophylaxis and therapy. Conventional coagulation assays-such as prothrombin time, partial thromboplastin time, and international normalized ratio-have historically been utilized to assess hemostasis and guide treatment following traumatic brain injury. However, these plasma-based assays alone often lack the sensitivity to diagnose and adequately treat coagulopathy associated with traumatic brain injury. Here, we review the whole blood coagulation assays termed viscoelastic tests and their use in traumatic brain injury. Modified viscoelastic tests with platelet function assays have helped elucidate the underlying pathophysiology and guide clinical decisions in a goal-directed fashion. Platelet dysfunction appears to underlie most coagulopathies in this patient population, particularly at the adenosine diphosphate and/or arachidonic acid receptors. Future research will focus not only on the utility of viscoelastic tests in diagnosing coagulopathy in traumatic brain injury, but also on better defining the use of these tests as evidence-based and/or precision-based tools to improve patient outcomes.
Databáze: MEDLINE
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