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首页> 外文期刊>ANZ journal of surgery >Thromboelastography does not provide additional information to guide resuscitation in the severely injured
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Thromboelastography does not provide additional information to guide resuscitation in the severely injured

机译：ThrocoBoelastography没有提供额外信息，以指导严重受伤的复苏

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Background Haemostasis assessment is essential to determine the early need for massive transfusion in the treatment of polytrauma. Strategies to guide correction of coagulopathy vary widely. In order to evaluate thromboelastography (TEG) for this goal, a prospective study was performed comparing TEG to conventional coagulation assays (CCAs) in severely injured patients. Methods Consecutive polytrauma patients admitted to the intensive care unit of a level‐1 trauma centre were prospectively included over a 30‐month period. All patients had CCA on arrival in emergency department. Patients who needed massive transfusion and underwent urgent surgery had additionally a Kaolin‐activated TEG. Results One hundred and thirty‐five patients were included, 76% male, median age 45 years, 96% blunt injuries and median injury severity score was 29. One hundred and fourteen patients had CCA only and 21 patients had both CCA and TEG. Patients who had both CCA and TEG were acidotic, hypothermic and coagulopathic on arrival in emergency department. All 21 patients had normal TEG results even though prothrombin time was prolonged. Conclusions TEGs were normal in all polytrauma patients even though patients were severely injured. They had prolonged prothrombin time, acidosis and hypothermia both on arrival and when TEG was measured. Caution should be exercised in interpretation of TEG results in treating polytrauma patients. In our system, with aggressive early haemostatic resuscitation, TEG does not provide additional information in guiding resuscitation.
机译：背景技术止血性评估对于确定在治疗多特拉姆治疗中的大规模输血的早期需求至关重要。指导凝血病变纠正的策略差异很大。为了评估该目标的血栓球摄影（TEG），对比较TEG在严重受伤的患者中将TEG进行比较至常规凝血测定（CCA）的前瞻性研究。方法预先录入1级创伤中心重症监护单元的连续聚特拉姆患者均在30个月内持续存在。所有患者均在抵达急诊部门时患有CCA。需要大量输血和接受紧急手术的患者另外是高岭土活化的TEG。结果包括一百三十五名患者，76％雄性，中位年龄45岁，钝性损伤96％，损伤严重程度得分为29.10元，只有14名患者只有CCA，21名患者都有CCA和TEG。患有CCA和TEG的患者在抵达急诊部门时是酸性，低温和凝血性疗法。所有21例患者都有正常的TEG结果，即使凝血酶原时间延长。结论结块在所有多重患者中都是正常的，尽管患者严重受伤。它们在抵达时常长的凝血酶原时间，酸中毒和体温过低，测量TEG时。注意应在TEG的解释中进行注意，导致治疗多重患者。在我们的系统中，具有激进的早期暂时复苏，TEG不提供引导复苏的额外信息。

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