NDLI: Thromboelastographic changes in patients experiencing an acute ischemic stroke and receiving alteplase.

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Thromboelastographic changes in patients experiencing an acute ischemic stroke and receiving alteplase.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rowe, A. Shaun Greene, Christal L. Snider, Carolyn C. Carroll, Roger C. Wiseman, Brian F. Henry, Jennifer M. Langdon, J. Russell Craft, Robert M.
Description	Author Affiliation: Rowe AS ( Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Knoxville, Tennessee. Electronic address: arowe@uthsc.edu.); Greene CL ( Department of Anesthesiology, University of Tennessee, Graduate School of Medicine, Knoxville, Tennessee.); Snider CC ( Department of Anesthesiology, University of Tennessee, Graduate School of Medicine, Knoxville, Tennessee.); Carroll RC ( Department of Anesthesiology, University of Tennessee, Graduate School of Medicine, Knoxville, Tennessee.); Wiseman BF ( Cole Neuroscience Center, Knoxville, Tennessee.); Henry JM ( Brain and Spine Institute, The University of Tennessee Medical Center, Knoxville, Tennessee.); Langdon JR ( Department of Anesthesiology, University of Tennessee, Graduate School of Medicine, Knoxville, Tennessee.); Craft RM ( Department of Anesthesiology, University of Tennessee, Graduate School of Medicine, Knoxville, Tennessee.)
Abstract	BACKGROUND: Thromboelastography is a method of measuring whole-blood coagulation changes and has been used to guide therapy and monitor changes in a variety of disease states. However, few studies have investigated the thromboelastographic changes experienced in a patient who has received alteplase for an acute ischemic stroke. This pilot study sought to describe the effect of alteplase on the thromboelastogram tracings of patients experiencing an acute ischemic stroke. METHODS: This was an institutional review board-approved prospective cohort study. Patients who presented to the emergency department with symptoms of acute ischemic stroke and received intravenous alteplase were evaluated for inclusion. Blood samples were obtained before alteplase administration and at 30, 60, 90, 120, and 150 minutes after alteplase administration. In addition, baseline variables collected included patient age, sex, prothrombin time, partial thromboplastin time, and the use of pretreatment anticoagulants or antiplatelet agents. Patients were also followed throughout their hospital stay for development of intracranial hemorrhage. RESULTS: A total of 7 patients were included in the analysis. At baseline, thromboelastogram parameters of all patients were within the normal range. The maximum inhibition of fibrin buildup was seen at 30 minutes after the start of alteplase infusion, and the lowest clot strength was observed at 60 minutes after initiation of alteplase. Most patients return to near baseline parameters within 150 minutes of alteplase initiation; however, 2 patients did not return to their baseline values within the 150-minute time frame. CONCLUSIONS: Our study suggests that thromboelastogram (TEG) is a useful tool for determining changes in the coagulation system of patients whom have received recombinant tissue plasminogen activator (rt-PA). Further study is needed to determine if TEG can be used to predict those patients who may be at higher risk of adverse events because of rt-PA.
File Format	HTM / HTML
ISSN	10523057
Issue Number	6
Volume Number	23
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2014-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Brain Ischemia Stroke Prospective Studies Thrombelastography Humans Middle Aged Drug Therapy Male Treatment Outcome Pharmacology Fibrinolytic Agents Aged, 80 And Over Drug Effects Blood Therapeutic Use Journal Article Tissue Plasminogen Activator Pilot Projects Discipline Cardiology Thrombolytic Therapy Blood Coagulation Female Aged
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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