Thromboelastometry for the assessment of coagulation abnormalities in early and established adult sepsis: a prospective cohort study
| Autor: | Hélène Folly, Fritz Daudel, Jasmin S Lienert, Ulf Kessler, Stephan M. Jakob, Jukka Takala |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Critical Care and Intensive Care Medicine Sepsis medicine Humans Prospective Studies Prospective cohort study Aged Hemostasis medicine.diagnostic_test business.industry Septic shock Research Organ dysfunction Blood Coagulation Disorders Middle Aged medicine.disease Surgery Thrombelastography Thromboelastometry Anesthesia SOFA score Female medicine.symptom business Partial thromboplastin time |
| Zdroj: | Critical Care Daudel, Fritz; Kessler, Ulf; Folly, Hélène; Lienert, Jasmin S; Takala, Jukka; Jakob, Stephan M (2009). Thromboelastometry for the assessment of coagulation abnormalities in early and established adult sepsis: a prospective cohort study. Critical care, 13(2), R42. London: BioMed Central 10.1186/cc7765 |
| ISSN: | 1466-609X |
| DOI: | 10.1186/cc7765 |
| Popis: | INTRODUCTION: The inflammatory response to an invading pathogen in sepsis leads to complex alterations in hemostasis by dysregulation of procoagulant and anticoagulant factors. Recent treatment options to correct these abnormalities in patients with sepsis and organ dysfunction have yielded conflicting results. Using thromboelastometry (ROTEM(R)), we assessed the course of hemostatic alterations in patients with sepsis and related these alterations to the severity of organ dysfunction. METHODS: This prospective cohort study included 30 consecutive critically ill patients with sepsis admitted to a 30-bed multidisciplinary intensive care unit (ICU). Hemostasis was analyzed with routine clotting tests as well as thromboelastometry every 12 hours for the first 48 hours, and at discharge from the ICU. Organ dysfunction was quantified using the Sequential Organ Failure Assessment (SOFA) score. RESULTS: Simplified Acute Physiology Score II and SOFA scores at ICU admission were 52 +/- 15 and 9 +/- 4, respectively. During the ICU stay the clotting time decreased from 65 +/- 8 seconds to 57 +/- 5 seconds (P = 0.021) and clot formation time (CFT) from 97 +/- 63 seconds to 63 +/- 31 seconds (P = 0.017), whereas maximal clot firmness (MCF) increased from 62 +/- 11 mm to 67 +/- 9 mm (P = 0.035). Classification by SOFA score revealed that CFT was slower (P = 0.017) and MCF weaker (P = 0.005) in patients with more severe organ failure (SOFA >or= 10, CFT 125 +/- 76 seconds, and MCF 57 +/- 11 mm) as compared with patients who had lower SOFA scores (SOFA |
| Databáze: | OpenAIRE |
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