잠시만 기다려 주세요. 로딩중입니다.

The role of rotational thromboelastometry during the COVID-19 pandemic: a narrative review

대한마취과학회지 2021년 74권 2호 p.91 ~ 102
Gorlinger Klaus, Almutawah Hawra, Almutawaa Fatimah, Alwabari Maryam, Alsultan Zahra, Almajed Jumanah, Alwabari Mahmoud, Alsultan Maryam, Shahwar Duri, Yassen Khaled Ahmed,
소속 상세정보
 ( Gorlinger Klaus ) - University Duisburg-Essen University Hospital Essen Department of Anesthesiology and Intensive Care Medicine
 ( Almutawah Hawra ) - King Faisal University College of Medicine
 ( Almutawaa Fatimah ) - King Faisal University College of Medicine
 ( Alwabari Maryam ) - King Faisal University College of Medicine
 ( Alsultan Zahra ) - King Faisal University College of Medicine
 ( Almajed Jumanah ) - King Faisal University College of Medicine
 ( Alwabari Mahmoud ) - King Faisal University College of Medicine
 ( Alsultan Maryam ) - King Faisal University College of Medicine
 ( Shahwar Duri ) - King Faisal University College of Medicine Department of Surgery
 ( Yassen Khaled Ahmed ) - King Faisal University College of Medicine Department of Surgery

Abstract


The coronavirus disease 2019 (COVID-19) pandemic is currently recognized as a global health crisis. This viral infection is frequently associated with hypercoagulability, with a high incidence of thromboembolic complications that can be fatal. In many situations, the standard coagulation tests (SCT) fail to detect this state of hypercoagulability in patients with COVID-19 since clotting times are either not or only mildly affected. The role of viscoelastic tests such as rotational thromboelastometry (ROTEM®) during this pandemic is explored in this review. COVID-19-associated coagulopathy, as measured using the rotational thromboelastometry parameters, can vary from hypercoagulability due to increased fibrin polymerization and decreased fibrinolysis to bleeding from hypocoagulability. The use of a multimodal diagnostic and monitoring approach, including both rotational thromboelastometry and SCT, such as plasma fibrinogen and D-dimer concentrations, is recommended. Rotational thromboelastometry provides comprehensive information about the full coagulation status of each patient and detects individual variations. Since COVID-19-associated coagulopathy is a very dynamic process, the phenotype can change during the course of infection and in response to anticoagulation therapy. Data from published literature provide evidence that the combination of rotational thromboelastometry and SCT analysis is helpful in detecting hemostasis issues, guiding anticoagulant therapy, and improving outcomes in COVID-19 patients. However, more research is needed to develop evidence-based guidelines and protocols.

키워드

Anticoagulants; Blood coagulation disorders; COVID-19; Fibrinolysis; SARSCoV-2; Thrombelastography; Thrombophilia; Thrombosis

원문 및 링크아웃 정보

 

등재저널 정보