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@article{1162107,
author = {Čundrle, Ivan Jr. and Šrámek, Vladimír and Pavlík, Martin and Suk, Pavel and Radouskova, Iveta and Zvoníček, Václav},
article_location = {London},
article_number = {2},
doi = {http://dx.doi.org/10.1097/EJA.0b013e32835c3716},
keywords = {cardiopulmonary resuscitation; hypothermia; thromboelastography},
language = {eng},
issn = {0265-0215},
journal = {European Journal of Anaesthesiology},
title = {Temperature corrected thromboelastography in hypothermia. Is it necessary?},
volume = {30},
year = {2013}
}
TY - JOUR
ID - 1162107
AU - Čundrle, Ivan Jr. - Šrámek, Vladimír - Pavlík, Martin - Suk, Pavel - Radouskova, Iveta - Zvoníček, Václav
PY - 2013
TI - Temperature corrected thromboelastography in hypothermia. Is it necessary?
JF - European Journal of Anaesthesiology
VL - 30
IS - 2
SP - 85-89
EP - 85-89
PB - Lippincott Williams and Wilkins
SN - 02650215
KW - cardiopulmonary resuscitation
KW - hypothermia
KW - thromboelastography
N2 - 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 degrees C) was indicated for 24 h were recruited to the study which lasted 36 h. 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 36 h. 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.
ER -
ČUNDRLE, Ivan Jr., Vladimír ŠRÁMEK, Martin PAVLÍK, Pavel SUK, Iveta RADOUSKOVA and Václav ZVONÍČEK. Temperature corrected thromboelastography in hypothermia. Is it necessary? \textit{European Journal of Anaesthesiology}. London: Lippincott Williams and Wilkins, 2013, vol.~30, No~2, p.~85-89. ISSN~0265-0215. Available from: https://dx.doi.org/10.1097/EJA.0b013e32835c3716.
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