Abstract
Thrombelastography (TEG) is used as a point-of-care test of hemostasis. Different components of the test tracing are considered to reflect various parts of the hemostatic system and to distinguish low platelet count, platelet dysfunction or both from lack of plasmatic coagulation factors. To analyze the influence of one single element of the coagulation system, namely the platelet count, we used TEG serially in patients with well documented transient thrombocytopenia. A total of 189 TEG analyses were performed from 16 patients with a hematological malignancy in remission, receiving consolidation courses of chemotherapy. TEG outcomes using unmanipulated and citrated blood samples at a median of 11 times (range 1-17) in the same patients during the decrease of platelet count in response to chemotherapy were compared with outcomes in 120 healthy adults from various age categories. We found a correlation (r = 0.7, P < 0.001) between TEG clot strength (maximum amplitude) and platelet count. Moreover, platelet count was correlated respectively with the initial rate of clot formation (reaction time and clotting time), the rate of clot growth (alpha angle), and also with maximum thrombus generation, time to maximum thrombus generation and total thrombus generation. We conclude that platelet count not only affects the strength of clot formation, as was expected, but also all other phases of plasmatic coagulation. Citration of the blood sample, aiming at easy storage of the material, masked some of the important biological parameters of coagulation.
Highlights
Кровопотеря является актуальной проблемой анестезиологии реаниматологии [1,2,3,4]
65% of births occuring through natural ways are accompanied by physio logical hemorrhage, in which one third of patients lose 500 to 1000 ml of blood/ In 3—8% of patients the amount of blood loss exceeds 1200—1500 ml that is considered as a massive obstetric hemorrhage (MOH) [7, 8]
The comparison group B comprised of 29 women, for whom the teratmet was conducted in compliance of a standard parame ters of the hemostatic system determined by routine laboratory methods
Summary
Акушерские кровотечения являются частыми и грозными осложне ниями беременности и родов, а в структуре причин ма теринской смертности они занимают 25—30% [5, 6]. Obstetric hemorrhage is frequent and serious complication of pregnancy and childbirth. It causes maternal mortality in 25—30% [5, 6]. 65% of births occuring through natural ways are accompanied by physio logical hemorrhage, in which one third of patients lose 500 to 1000 ml of blood/ In 3—8% of patients the amount of blood loss exceeds 1200—1500 ml that is considered as a massive obstetric hemorrhage (MOH) [7, 8].
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