Single article

DOI: 10.47026/2413-4864-2021-3-18-25

Kostrova O.Yu., Stomenskaya I.S., Timofeeva N.Yu., Buryachenko N.A., Dobrohotov M.Z., Struchko G.Yu., Kazakov A.V.

Thromboelastography in Assessing the Hemostatic System in Intensive Care Patients

Keywords: thromboelastography, coagulogram, resuscitation, diagnostics, external hemostasis, internal hemostasis, analyzer, trauma, hypocoagulation, hypercoagulation

The results of thromboelastography and standard coagulogram were analyzed in 35 patients aged from 18 to 86 who were treated in the resuscitation and intensive care unit. The majority of patients (34%) were hospitalized in the department with multisystem and concomitant injuries. The remaining patients were taken to the medical institution with different diagnoses (urolithiasis, liver cirrhosis, pancreatic lesion of various types, poisoning, peptic ulcer, sepsis). The data of coagulogram and thromboelastography at different stages of treatment were compared. In patients with the development of traumatic shock, the coagulogram parameters were changed to varying degrees depending on the stage of shock. At the first stage of shock, only an increase in soluble fibrin-monomer complexes by almost 2 times and a slight increase in fibrinogen dynamics were noted in the analysis. In a patient with stage 3 traumatic shock, the coagulogram parameters were within the normal range, but according to thromboelastography (EXTEM and FIBTEM tests), hypocoagulation due to the platelet link was noted. Only the coagulogram was evaluated in dynamics, hypocoagulation was noted in the indicators of internal and external hemostasis pathways: lengthening of the activated partial thromboplastin time, a decrease in the prothrombin index and an increase in the international normalized ratio, an increase in fibrinogen A and soluble fibrin-monomer complexes. In the group of male patients with closed craniocerebral trauma, an increase in soluble fibrin-monomer complexes in the coagulogram was always combined with changes in the FIBTEM test during thromboelastography. In most patients, no changes in the classical coagulogram tests immediately after the injury are noted. At this, thromboelastography makes it possible to make up for this deficiency at an earlier time, which indicates a high sensitivity of the method.

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About authors

Kostrova Olga Yu.
Candidate of Medical Sciences, Assistant Professor, Head of Department of the Instrumental Diagnostics with a Course of Phthisiology, Chuvash State University, Russia, Cheboksary (evkbiz@yandex.ru; ORCID: https://orcid.org/0000-0002-7057-9834)
Stomenskaya Irina S.
Candidate of Medical Sciences, Assistant Professor, Department of the Instrumental Diagnostics with a Course of Phthisiology, Chuvash State University, Russia, Cheboksary (irina.stomenskaja@gmail.com; ORCID: https://orcid.org/0000-0001-7332-4477)
Timofeeva Natalya Yu.
Assistant Lecturer, Department of Instrumental Diagnostics Department with a Course of Phthisiology, Chuvash State University, Russia, Cheboksary (bla11blabla@yandex.ru; ORCID: https://orcid.org/0000-0002-7596-0132)
Buryachenko Natalya A.
Transfusiologist, Moscow State Budgetary Healthcare Institution «City Clinical Hospital № 67 named after L.A. Vorokhobova» Moscow Department of Health, Russia, Moscow (ORCID: https://orcid.org/0000-0002-7858-7994)
Dobrokhotov Mikhail Z.
Head of the Department of Gravity Blood Surgery and Hyperbaric Oxygenation, Emergency Hospital, Russia, Cheboksary (dobro_cheb@mail.ru; ORCID: https://orcid.org/0000-0001-6817-5841)
Struchko Gleb Yu.
Doctor of Medical Sciences, Professor, Head of Normal and Topographic Anatomy Department, Chuvash State University, Russia, Cheboksary (glebstr@mail.ru; ORCID: https://orcid.org/0000-0002-0549-5116)
Kazakov Alexander V.
Anesthetist-Resuscitator, Emergency Hospital, Russia, Cheboksary (sashadorian02@gmail.com; )

Article link

Kostrova O.Yu., Stomenskaya I.S., Timofeeva N.Yu., Buryachenko N.A., Dobrohotov M.Z., Struchko G.Yu., Kazakov A.V. Thromboelastography in Assessing the Hemostatic System in Intensive Care Patients [Electronic resource] // Acta medica Eurasica. – 2021. – №3. P. 18-25. – URL: http://acta-medica-eurasica.ru/en/single/2021/3/3/. DOI: 10.47026/2413-4864-2021-3-18-25.