Thromboelastography for Evaluation of Coagulopathy in Nonbleeding Patients with Sepsis at Intensive Care Unit Admission

Thromboelastography (TEG) is a global test of coagulation which analyzes the whole coagulation process. TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with s...

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Published in:Indian journal of critical care medicine 2017-05, Vol.21 (5), p.268-273
Main Authors: Muzaffar, Syed Nabeel, Baronia, Arvind Kumar, Azim, Afzal, Verma, Anupam, Gurjar, Mohan, Poddar, Banani, Singh, Ratender Kumar
Format: Article
Language:English
Subjects:
Analysis
Anticoagulants
Blood products
Computer software industry
Critical care
Ethical aspects
Heart surgery
Hematology
Illnesses
Infection
Intensive care
Laboratories
Medicine
Mortality
Sepsis
Transplantation of organs, tissues, etc
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cited_by cdi_FETCH-LOGICAL-c563t-9be0b9eb51315c028d2bcbb655fe1dc0b4c4e3a4d27e0d4a6b65588e9addde033
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container_end_page 273
container_issue 5
container_start_page 268
container_title Indian journal of critical care medicine
container_volume 21
creator Muzaffar, Syed Nabeel
Baronia, Arvind Kumar
Azim, Afzal
Verma, Anupam
Gurjar, Mohan
Poddar, Banani
Singh, Ratender Kumar
description Thromboelastography (TEG) is a global test of coagulation which analyzes the whole coagulation process. TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014. After ethical clearance, all patients at ICU admission with sepsis were included in the study. Exclusion criteria were age
doi_str_mv 10.4103/ijccm.IJCCM_72_17
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TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014. After ethical clearance, all patients at ICU admission with sepsis were included in the study. Exclusion criteria were age &lt;18 years, plasma/platelet transfusion before admission, patients on oral antiplatelets/anticoagulants, or with underlying hematological disorders. At admission, blood samples for TEG were analyzed by kaolin-based TEG analyzer within an hour of collecting 2.7 ml citrated blood from arterial line. TEG parameters included reaction time (R), K time (K), alpha angle (a), maximum amplitude (MA), coagulation index (CI), and lysis index (LY 30). In TEG, mean values of R, K, a, MA, CI, and LY30 were 6.45 ± 2.59 (min), 1.67 ± 0.96 (min), 66.37 ± 10.44 ( ), 67.08 ± 10.33 (mm), 0.63 ± 3.46, and 2.23 ± 4.08 (%), respectively. In conventional coagulation assay (CCA), mean values of international normalized ratio (INR), platelet, and fibrinogen were 1.63 ± 0.57, 153.96 ± 99.16 (×10 /mm ), and 301.33 ± 112.82 (mg/dl), respectively. In those with deranged INR (INR ≥1.6), 60% were normocoagulable and 20% were hypercoagulable. Similarly, 81% patients with thrombocytopenia (platelet count &lt;1,00,000/mL) were normocoagulable. TEG could differentiate among normocoagulant, hypocoagulant, hypercoagulant states (unlike CCAs). 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TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014. After ethical clearance, all patients at ICU admission with sepsis were included in the study. Exclusion criteria were age &lt;18 years, plasma/platelet transfusion before admission, patients on oral antiplatelets/anticoagulants, or with underlying hematological disorders. At admission, blood samples for TEG were analyzed by kaolin-based TEG analyzer within an hour of collecting 2.7 ml citrated blood from arterial line. TEG parameters included reaction time (R), K time (K), alpha angle (a), maximum amplitude (MA), coagulation index (CI), and lysis index (LY 30). 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subjects Analysis
Anticoagulants
Blood products
Computer software industry
Critical care
Ethical aspects
Heart surgery
Hematology
Illnesses
Infection
Intensive care
Laboratories
Medicine
Mortality
Sepsis
Transplantation of organs, tissues, etc
title Thromboelastography for Evaluation of Coagulopathy in Nonbleeding Patients with Sepsis at Intensive Care Unit Admission
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