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- Title
Diagnostic potential and limitations of thrombelastography/-metry.
- Authors
Lang T; von Depka M
- Abstract
Thrombelastography/-metry provides information about clot firmness and stability. The use of standardized tests, such as FibTEM, allows estimation of platelet and plasmatic component of clot strength. This may lead to therapeutic consequences. However, estimation of clot strength by platelet count and fibrinogen determination according to Clauss is not feasible. This may be explained by the dynamic interaction of platelets and fibrinogen. Dysfibrinogenemia and factor XIII may also modify clot strength. Diagnosis of hyperfibrinolysis in the perioperative setting is impossible by the use of the D-dimer test. Thrombelastography/-metry is considered the 'gold standard' of diagnosis of hyperfibrinolysis. Disorders in primary hemostasis, such as von Willebrand disease, and drug effects (ASS or clopidogrel) may not be detected by thrombelastography/-metry (with the exception of platelet mapping). Indications for thrombelastography/-metry are unexplained intra- and post-operative bleeding disorders. Thrombelastography/ -metry may be useful in monitoring of fibrinogen substitution. Thrombelastometry (ROTEM[R]) allows generation of valid and reproducible thrombelastometric curves even under clinical conditions.
- Publication
Journal of Laboratory Medicine / Laboratoriums Medizin, 2007, Vol 31, Issue 6, p254
- ISSN
0342-3026
- Publication type
Journal Article