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Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures

The application of viscoelastic hemostatic assays (VHAs) (e.g., thromboelastography (TEG) and rotational thromboelastometry (ROTEM)) in orthopedics is in its relative infancy when compared with other surgical fields. Fortunately, several recent studies describe the emerging use of VHAs to quickly an...

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Autores principales: Mamczak, Christiaan N., Speybroeck, Jacob, Stillson, John E., Dynako, Joseph, Piscoya, Andres, Peck, Ethan E., Aboukhaled, Michael, Cancel, Emily, McDonald, Michael, Garcia, Diego, Lovejoy, John, Lubin, Stephanie, Stanton, Robert, Kutcher, Matthew E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323142/
https://www.ncbi.nlm.nih.gov/pubmed/35887803
http://dx.doi.org/10.3390/jcm11144029
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author Mamczak, Christiaan N.
Speybroeck, Jacob
Stillson, John E.
Dynako, Joseph
Piscoya, Andres
Peck, Ethan E.
Aboukhaled, Michael
Cancel, Emily
McDonald, Michael
Garcia, Diego
Lovejoy, John
Lubin, Stephanie
Stanton, Robert
Kutcher, Matthew E.
author_facet Mamczak, Christiaan N.
Speybroeck, Jacob
Stillson, John E.
Dynako, Joseph
Piscoya, Andres
Peck, Ethan E.
Aboukhaled, Michael
Cancel, Emily
McDonald, Michael
Garcia, Diego
Lovejoy, John
Lubin, Stephanie
Stanton, Robert
Kutcher, Matthew E.
author_sort Mamczak, Christiaan N.
collection PubMed
description The application of viscoelastic hemostatic assays (VHAs) (e.g., thromboelastography (TEG) and rotational thromboelastometry (ROTEM)) in orthopedics is in its relative infancy when compared with other surgical fields. Fortunately, several recent studies describe the emerging use of VHAs to quickly and reliably analyze the real-time coagulation and fibrinolytic status in both orthopedic trauma and elective orthopedic surgery. Trauma-induced coagulopathy—a spectrum of abnormal coagulation phenotypes including clotting factor depletion, inadequate thrombin generation, platelet dysfunction, and dysregulated fibrinolysis—remains a potentially fatal complication in severely injured and/or hemorrhaging patients whose timely diagnosis and management are aided by the use of VHAs. Furthermore, VHAs are an invaluable compliment to common coagulation tests by facilitating the detection of hypercoagulable states commonly associated with orthopedic injury and postoperative status. The use of VHAs to identify hypercoagulability allows for an accurate venous thromboembolism (VTE) risk assessment and monitoring of VTE prophylaxis. Until now, the data have been insufficient to permit an individualized approach with regard to dosing and duration for VTE thromboprophylaxis. By incorporating VHAs into routine practice, orthopedic surgeons will be better equipped to diagnose and treat the complete spectrum of coagulation abnormalities faced by orthopedic patients. This work serves as an educational primer and up-to-date review of the current literature on the use of VHAs in orthopedic surgery.
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spelling pubmed-93231422022-07-27 Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures Mamczak, Christiaan N. Speybroeck, Jacob Stillson, John E. Dynako, Joseph Piscoya, Andres Peck, Ethan E. Aboukhaled, Michael Cancel, Emily McDonald, Michael Garcia, Diego Lovejoy, John Lubin, Stephanie Stanton, Robert Kutcher, Matthew E. J Clin Med Review The application of viscoelastic hemostatic assays (VHAs) (e.g., thromboelastography (TEG) and rotational thromboelastometry (ROTEM)) in orthopedics is in its relative infancy when compared with other surgical fields. Fortunately, several recent studies describe the emerging use of VHAs to quickly and reliably analyze the real-time coagulation and fibrinolytic status in both orthopedic trauma and elective orthopedic surgery. Trauma-induced coagulopathy—a spectrum of abnormal coagulation phenotypes including clotting factor depletion, inadequate thrombin generation, platelet dysfunction, and dysregulated fibrinolysis—remains a potentially fatal complication in severely injured and/or hemorrhaging patients whose timely diagnosis and management are aided by the use of VHAs. Furthermore, VHAs are an invaluable compliment to common coagulation tests by facilitating the detection of hypercoagulable states commonly associated with orthopedic injury and postoperative status. The use of VHAs to identify hypercoagulability allows for an accurate venous thromboembolism (VTE) risk assessment and monitoring of VTE prophylaxis. Until now, the data have been insufficient to permit an individualized approach with regard to dosing and duration for VTE thromboprophylaxis. By incorporating VHAs into routine practice, orthopedic surgeons will be better equipped to diagnose and treat the complete spectrum of coagulation abnormalities faced by orthopedic patients. This work serves as an educational primer and up-to-date review of the current literature on the use of VHAs in orthopedic surgery. MDPI 2022-07-12 /pmc/articles/PMC9323142/ /pubmed/35887803 http://dx.doi.org/10.3390/jcm11144029 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mamczak, Christiaan N.
Speybroeck, Jacob
Stillson, John E.
Dynako, Joseph
Piscoya, Andres
Peck, Ethan E.
Aboukhaled, Michael
Cancel, Emily
McDonald, Michael
Garcia, Diego
Lovejoy, John
Lubin, Stephanie
Stanton, Robert
Kutcher, Matthew E.
Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title_full Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title_fullStr Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title_full_unstemmed Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title_short Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures
title_sort viscoelastic hemostatic assays for orthopedic trauma and elective procedures
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323142/
https://www.ncbi.nlm.nih.gov/pubmed/35887803
http://dx.doi.org/10.3390/jcm11144029
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