Hernández-Pérez AL, Ramírez-Morales K, Lagarda-Cuevas J, Revilla-Monsalve C, Bermúdez-Ochoa GM, Juárez-Pichardo JS, Gallardo-Hernández AG

Language: Spanish
References: 23
Page: 48-59
PDF size: 510.03 Kb.

ABSTRACT

Conventional coagulation tests evaluate the time in which the coagulation factors are activated in the blood plasma, which lacks cellular components such as enzymes and platelets that are involved in the development of hemostasis. Thromboelastography (TEG) performs an in vitro analysis of the relationship between platelets, enzymes, fibrinogen, and other coagulation elements in an integral way; reason why it is used more frequently in cardiac surgeries, transplants, and surgeries of arteriovenous malformations, where the expected blood loss is greater than 40% of the circulating blood volume. The inclusion of TEG in the pre-anesthetic evaluation allows evaluating platelet activity in patients who use antiplatelets therapy, such as clopidogrel or acetylsalicylic acid, through platelet mapping (Platelet Mapping^®). When bleeding occurs in the trans-anesthetic period, TEG specifically identifies the type of treatment necessary to improve coagulation or transfusion of formed blood elements. The TEG allows more sophisticated transfusion therapy protocols to be carried out, which implies a decrease in complications associated with polytransfusion and a reduction in costs, so these benefits justify the routine use of TEG for any general surgery.

REFERENCES

1. Chuquimia Zarate LD, Flores Pilco YMR. Hemostasia coagulación y transfusión sanguínea en cirugía. Rev. Act Clin Med. 2011;15:876-879.

2. Versteeg HH, Heemskerk JW, Levi M, Reitsma PH. New fundamentals in hemostasis. Physiol Rev. 2013;93:327-358.

3. Yan Y, Xu LC, Vogler EA, Siedlecki CA. Contact activation by the intrinsic pathway of blood plasma coagulation. In: Siedlecki CA. Hemocompatibility of biomaterials for clinical applications: blood-biomaterials interactions. Oxford, UK: Woodhead Publishing; 2018. pp. 3-28.

4. Ceresetto JM. Global interpretation of coagulation tests. Hematología. 2017;21:69-76.

5. Pant A, Kopec AK, Luyendyk JP. Role of the blood coagulation cascade in hepatic fibrosis. Am J Physiol Gastrointest Liver Physiol. 2018;315:G171-G176.

6. Guerrero B, López M. Generalidades del sistema de la coagulación y pruebas para su estudio. Invest Clín. 2015;56:432-454.

7. Galvez K, Cortes C. Tromboelastografía: nuevos conceptos en la fisiología. Rev Colomb Anestesiol. 2012;40:224-230.

8. Cervera Bravo A. Fisiopatología y trastornos de la coagulación hereditarios más frecuentes. Pediatr Integral. 2012;16:387-398.

9. Maegele M, Schochl H, Cohen MJ. An update on the coagulopathy of trauma. Shock. 2014;41 Suppl 1:21-25.

10. López-Santiago N. Pruebas de coagulación. Acta Pediatr Mex. 2016;37:241-245.

11. Zimring JC. Introduction to coagulation testing. In: Hillyer CD, Shaz BH, Zimring JC, Abshire TC, editors. Transfusion medicine and hemostasis, clinical and laboratory aspects. New York, USA: Elsevier; 2009. pp. 601-605.

12. Flores-Rivera OI, Ramírez-Morales K, Meza-Márquez JM et al. Fisiología de la coagulación. Rev Mex Anest. 2014;37:382-386.

13. Macafee B, Campbell JP, Ashpole K, Cox M, Matthey F, Acton L, et al. Reference ranges for thromboelastography (TEG(®) ) and traditional coagulation tests in term parturients undergoing caesarean section under spinal anaesthesia. Anaesthesia. 2012;67:741-747.

14. Wikkelso A, Wetterslev J, Moller AM, Afshari A. Thromboelastography (TEG) or rotational thromboelastometry (ROTEM) to monitor haemostatic treatment in bleeding patients: a systematic review with meta-analysis and trial sequential analysis. Anaesthesia. 2017;72:519-531.

15. Pérez-Calatayud AA, Giraldo-Cadavid LF, Aguilar-Vidales K, Loza-Gallardo LR, Escobar-Herrera G, González-Hernández J, et al. Informe del primer caso de manejo transfusional guiado por tromboelastometría rotacional en México y revisión de la bibliografía . Cir Cir. 2019;87:1-7.

16. Barraza-Cervantes AJ, Díaz-Franco SD, Sosa-García JO. Tromboelastografía como guía para la toma de decisiones en el perioperatorio. Rev Mex Anest. 2015;38:277-284.

17. Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA. Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg. 1999;88:312-319.

18. Franceschi JL. Tromboelastografía y sus aplicaciones clínicas. Rev Med Panama. 2015;35:30-35.

19. Weitzel NS, Weitzel LB, Epperson LE, Karimpour-Ford A, Tran ZV, Seres T. Platelet mapping as part of modified thromboelastography (TEG®) in patients undergoing cardiac surgery and cardiopulmonary bypass. Anaesthesia. 2012;67:1158-1165.

20. Cruz-Guerrero RF, Jiménez-Ávila JM, González-Cisneros AC, Rivera-Villa AH, Sánchez-Chávez FA, Rincón-Gómez MR, et al. Almidón como factor de riesgo para el incremento del sangrado transquirúrgico en la artroplastia total de cadera. Cir Cir. 2019;87:164-169.

21. Crisóstomo-Pineda MM, Hernández-Pérez AL, Ordóñez-Espinosa G, Riera-Kinkel C. La hipotermia y sus efectos durante la anestesia en niños. Rev Mex Pediatr. 2011;78:131-138.

22. Sherrod BA, Baker DK, Gilbert SR. Blood transfusion incidence, risk factors, and associated complications in surgical treatment of hip dysplasia. J Pediatr Orthop. 2018;38:208-216.

23. Maldonado Rojas M, Piña Farías L, Vásquez Rojas M, Toro Opazo C. Complicaciones asociadas a la transfusión masiva. Rev Cubana Hematol Inmunol Hemoter. 2013;29:46-61.