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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Cundrle, Ivan Sramek, Vladimir Pavlik, Martin Suk, Pavel Radouskova, Iveta Zvonicek, Vaclav |
| Description | Country affiliation: Czech Republic Author Affiliation: Cundrle I ( Department of Anaesthesiology and Intensive Care, Masaryk University, St Anna's University Hospital, Brno, Czech Republic.) |
| Abstract | CONTEXT: Hypothermia is known to influence thromboelastography (TEG). TEG reproducibility is generally low. OBJECTIVE: The aim of this study was to evaluate the rationale of TEG temperature adjustment in patients during hypothermia. We hypothesised that temperature adjustment would not be important because of low TEG reproducibility. DESIGN: Prospective observational study. SETTING: Single-centre, secondary care study performed 01/2009 to 07/2010. PATIENTS: Survivors of cardiopulmonary resuscitation in whom therapeutic hypothermia (32 to 34°C) was indicated for 24âh were recruited to the study which lasted 36âh. Four hundred samples from 30 patients (22 men and eight women) were obtained. No specific exclusion criteria were defined. MAIN OUTCOME MEASURES: Temperature adjusted and non-adjusted Kaolin-Heparinase and Rapid-TEG were done at 12-h intervals during the first 36âh. RESULTS: Bland-Altman plots were used for analysis. During hypothermia, the bias of adjusted measurements was greater in clot formation variables for both Kaolin-Heparinase-TEG (from -15 to -19%) and Rapid-TEG (-9 to -25%) compared to normothermia (from -3 to 3% for Kaolin-Heparinase-TEG and -10 to 2% for Rapid-TEG). Bias of clot strength variables was not influenced by temperature adjustment (median -1%). The 95% limits of agreement were wide for clot formation variables and independent of temperature. In Kaolin-Heparinase-TEG (R -42 to 40% normothermia, -47 to 18% hypothermia) and in Rapid-TEG (R -117 to 97% normothermia, -114 to 95% hypothermia). Limits of agreement of clot strength variables were narrower and independent of temperature in Kaolin-Heparinase-TEG (MA -16 to 13% normothermia, -9 to 10% hypothermia) and also in Rapid-TEG (MA -27 to 24% normothermia, -18 to 20% hypothermia). CONCLUSION: Although TEG analysis with temperature adjusted to the in-vivo value during hypothermia yields results with small systematic bias, the importance of temperature adjustment in clinical routine is low because of the precision limits of TEG measurement itself. Therefore, we see no need to perform TEG analysis at the in-vivo temperature. |
| File Format | HTM / HTML |
| ISSN | 02650215 |
| Issue Number | 2 |
| Volume Number | 30 |
| e-ISSN | 13652346 |
| Journal | European Journal of Anaesthesiology |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2013-02-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Anesthesiology Cardiopulmonary Resuscitation Methods Hypothermia, Induced Thrombelastography Aged Standards Cardiovascular Diseases Epidemiology Therapy Female Humans Male Middle Aged Prospective Studies Journal Article Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine |
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