Clinical significance of thromboelastometry parameters: 616‐005.1‐08

Abstract

Summary. Introduction. Thromboelastometry (TEM) enables comprehensive characterization of all stages of blood clot formation, as well as the assessment of its quality and stability. The TEM system performs tests with activators (EXTEM, INTEM, and FIBTEM), which allow for evaluation of various hemostasis components. TEM parameters are used for point‐of‐care (POC) diagnosis of hemostatic disorders. Аim: to characterize the parameters of tests with activators (EXTEM, INTEM, FIBTEM), determine their relationship with coagulation hemostasis and blood cells, and clarify the TEM scope in clinical practice. Materials and Methods. The cross‐sectional study included 48 blood donors. We studied the parameters of the hemogram, concentration of fibrinogen and plasminogen (PLG), antithrombin activity, proteins C (PrC) and S, coagulation factors (F) VII, VIII and XIII, von Willebrand factor antigen (vWF:Ag) and vWF activity (vWF:RCo), activated partial thromboplastin time (aPTT), thrombin time (TT), prothrombin time (PT), and international normalized ratio (INR), as well as TEM parameters (EXTEM, INTEM, FIBTEM). Results. The time of the СТEXTEM was found to correlate with the PT (r=0.388; р=0.0456), FVIII (r=0,463; р=0,0131), vWF:Ag (r=0.475; р=0.0106), and PrС (r=0.404; р=0.0331). The time of the CTINTEM correlated with аPTT (r=0.425; p=0.0271) and with FVIII (r=–0.530; p=0.0037). Structural parameters (A5, A10, A20, and MCF) and trombodynamic potential index (TPI) of all tests depended on fibrinogen, with the greatest correlation observed in A10 FIBTEM (r = 0.780; p < 0.0001). The platelet count was found to be depend on CFT, angle α, and all structural parameters of the EXTEM and INTEM tests. The RBC count did not affect EXTEM, INTEM, and FIBTEM parameters. The MLINTEM parameter exhibited a correlation with the leukocyte level (r=–0.407; p=0.0351). Conclusion. EXTEM, INTEM, and FIBTEM enable the assessment of the activity of factors related to the external and internal coagulation pathways, fibrinogen concentration, platelet functional activity, and fibrinolysis activity. The rapidly obtained results allow using tests with activators for express diagnosis of hemostasis condition.

For citation: Beznoshchenko O.S., Fedorova T.A., Strelnikova E.V., Gorodnova E.A., Pyregov A.V., Silaev B.V. Clinical significance of thromboelastometry parameters. Tromboz, gemostaz i reologiya. 2024;(3):107–177. (In Russ.).

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