Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients

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Standard

Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients. / Vigstedt, Martin; Baksaas-Aasen, Kjersti; Henriksen, Hanne H.; Maegele, Marc; Stanworth, Simon; Juffermans, Nicole P.; Kolstadbråten, Knut M.; Naess, Pål A.; Brohi, Karim; Gaarder, Christine; Stensballe, Jakob; Johansson, Pär I.

In: Scandinavian Journal of Clinical and Laboratory Investigation, Vol. 82, No. 6, 2022, p. 508-512.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Vigstedt, M, Baksaas-Aasen, K, Henriksen, HH, Maegele, M, Stanworth, S, Juffermans, NP, Kolstadbråten, KM, Naess, PA, Brohi, K, Gaarder, C, Stensballe, J & Johansson, PI 2022, 'Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients', Scandinavian Journal of Clinical and Laboratory Investigation, vol. 82, no. 6, pp. 508-512. https://doi.org/10.1080/00365513.2022.2119599

APA

Vigstedt, M., Baksaas-Aasen, K., Henriksen, H. H., Maegele, M., Stanworth, S., Juffermans, N. P., Kolstadbråten, K. M., Naess, P. A., Brohi, K., Gaarder, C., Stensballe, J., & Johansson, P. I. (2022). Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients. Scandinavian Journal of Clinical and Laboratory Investigation, 82(6), 508-512. https://doi.org/10.1080/00365513.2022.2119599

Vancouver

Vigstedt M, Baksaas-Aasen K, Henriksen HH, Maegele M, Stanworth S, Juffermans NP et al. Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients. Scandinavian Journal of Clinical and Laboratory Investigation. 2022;82(6):508-512. https://doi.org/10.1080/00365513.2022.2119599

Author

Vigstedt, Martin ; Baksaas-Aasen, Kjersti ; Henriksen, Hanne H. ; Maegele, Marc ; Stanworth, Simon ; Juffermans, Nicole P. ; Kolstadbråten, Knut M. ; Naess, Pål A. ; Brohi, Karim ; Gaarder, Christine ; Stensballe, Jakob ; Johansson, Pär I. / Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients. In: Scandinavian Journal of Clinical and Laboratory Investigation. 2022 ; Vol. 82, No. 6. pp. 508-512.

Bibtex

@article{71d5a05a3966479298e90e13a1b3ea96,
title = "Thrombelastography (TEG{\textregistered} 6s) early amplitudes predict maximum amplitude in severely injured trauma patients",
abstract = "Severely injured trauma patients are often coagulopathic and early hemostatic resuscitation is essential. Previous studies have revealed linear relationships between thrombelastography (TEG{\textregistered}) five- and ten-min amplitudes (A5 and A10), and maximum amplitude (MA), using TEG{\textregistered} 5000 technology. We aimed to investigate the performance of A5 and A10 in predicting low MA in severely injured trauma patients and identify optimal cut-off values for hemostatic intervention based on early amplitudes, using the cartridge-based TEG{\textregistered} 6s technology. Adult trauma patients with hemorrhagic shock were included in the iTACTIC randomized controlled trial at six European Level I trauma centers between 2016 and 2018. After admission, patients were randomized to hemostatic therapy guided by conventional coagulation tests (CCT) or viscoelastic hemostatic assays (VHA). Patients with available admission-TEG{\textregistered} 6s data were included in the analysis, regardless of treatment allocation. Low MA was defined as <55 mm for Kaolin TEG{\textregistered} and RapidTEG{\textregistered}, and <17 mm for TEG{\textregistered} functional fibrinogen (FF). One hundred eighty-seven patients were included. Median time to MA was 20 (Kaolin TEG{\textregistered}), 21 (RapidTEG{\textregistered}) and 12 (TEG{\textregistered} FF) min. For Kaolin TEG{\textregistered}, the optimal Youden index (YI) was at A5 < 36 mm (100/93% sensitivity/specificity) and A10 < 47 mm (100/96% sensitivity/specificity). RapidTEG{\textregistered} optimal YI was at A5 < 34 mm (98/92% sensitivity/specificity) and A10 < 45 mm (96/95% sensitivity/specificity). TEG{\textregistered} FF optimal YI was at A5 < 12 mm (97/93% sensitivity/specificity) and A10 < 15 mm (97/99% sensitivity/specificity). In summary, we found that TEG{\textregistered} 6s early amplitudes were sensitive and specific predictors of MA in severely injured trauma patients. Intervening on early amplitudes can save valuable time in hemostatic resuscitation.",
keywords = "Blood coagulation, hemostasis, shock, thrombelastography, trauma",
author = "Martin Vigstedt and Kjersti Baksaas-Aasen and Henriksen, {Hanne H.} and Marc Maegele and Simon Stanworth and Juffermans, {Nicole P.} and Kolstadbr{\aa}ten, {Knut M.} and Naess, {P{\aa}l A.} and Karim Brohi and Christine Gaarder and Jakob Stensballe and Johansson, {P{\"a}r I.}",
note = "Publisher Copyright: {\textcopyright} 2022 Medisinsk Fysiologisk Forenings Forlag (MFFF).",
year = "2022",
doi = "10.1080/00365513.2022.2119599",
language = "English",
volume = "82",
pages = "508--512",
journal = "Scandinavian Journal of Clinical and Laboratory Investigation. Supplement",
issn = "0085-591X",
publisher = "Taylor & Francis",
number = "6",

}

RIS

TY - JOUR

T1 - Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients

AU - Vigstedt, Martin

AU - Baksaas-Aasen, Kjersti

AU - Henriksen, Hanne H.

AU - Maegele, Marc

AU - Stanworth, Simon

AU - Juffermans, Nicole P.

AU - Kolstadbråten, Knut M.

AU - Naess, Pål A.

AU - Brohi, Karim

AU - Gaarder, Christine

AU - Stensballe, Jakob

AU - Johansson, Pär I.

N1 - Publisher Copyright: © 2022 Medisinsk Fysiologisk Forenings Forlag (MFFF).

PY - 2022

Y1 - 2022

N2 - Severely injured trauma patients are often coagulopathic and early hemostatic resuscitation is essential. Previous studies have revealed linear relationships between thrombelastography (TEG®) five- and ten-min amplitudes (A5 and A10), and maximum amplitude (MA), using TEG® 5000 technology. We aimed to investigate the performance of A5 and A10 in predicting low MA in severely injured trauma patients and identify optimal cut-off values for hemostatic intervention based on early amplitudes, using the cartridge-based TEG® 6s technology. Adult trauma patients with hemorrhagic shock were included in the iTACTIC randomized controlled trial at six European Level I trauma centers between 2016 and 2018. After admission, patients were randomized to hemostatic therapy guided by conventional coagulation tests (CCT) or viscoelastic hemostatic assays (VHA). Patients with available admission-TEG® 6s data were included in the analysis, regardless of treatment allocation. Low MA was defined as <55 mm for Kaolin TEG® and RapidTEG®, and <17 mm for TEG® functional fibrinogen (FF). One hundred eighty-seven patients were included. Median time to MA was 20 (Kaolin TEG®), 21 (RapidTEG®) and 12 (TEG® FF) min. For Kaolin TEG®, the optimal Youden index (YI) was at A5 < 36 mm (100/93% sensitivity/specificity) and A10 < 47 mm (100/96% sensitivity/specificity). RapidTEG® optimal YI was at A5 < 34 mm (98/92% sensitivity/specificity) and A10 < 45 mm (96/95% sensitivity/specificity). TEG® FF optimal YI was at A5 < 12 mm (97/93% sensitivity/specificity) and A10 < 15 mm (97/99% sensitivity/specificity). In summary, we found that TEG® 6s early amplitudes were sensitive and specific predictors of MA in severely injured trauma patients. Intervening on early amplitudes can save valuable time in hemostatic resuscitation.

AB - Severely injured trauma patients are often coagulopathic and early hemostatic resuscitation is essential. Previous studies have revealed linear relationships between thrombelastography (TEG®) five- and ten-min amplitudes (A5 and A10), and maximum amplitude (MA), using TEG® 5000 technology. We aimed to investigate the performance of A5 and A10 in predicting low MA in severely injured trauma patients and identify optimal cut-off values for hemostatic intervention based on early amplitudes, using the cartridge-based TEG® 6s technology. Adult trauma patients with hemorrhagic shock were included in the iTACTIC randomized controlled trial at six European Level I trauma centers between 2016 and 2018. After admission, patients were randomized to hemostatic therapy guided by conventional coagulation tests (CCT) or viscoelastic hemostatic assays (VHA). Patients with available admission-TEG® 6s data were included in the analysis, regardless of treatment allocation. Low MA was defined as <55 mm for Kaolin TEG® and RapidTEG®, and <17 mm for TEG® functional fibrinogen (FF). One hundred eighty-seven patients were included. Median time to MA was 20 (Kaolin TEG®), 21 (RapidTEG®) and 12 (TEG® FF) min. For Kaolin TEG®, the optimal Youden index (YI) was at A5 < 36 mm (100/93% sensitivity/specificity) and A10 < 47 mm (100/96% sensitivity/specificity). RapidTEG® optimal YI was at A5 < 34 mm (98/92% sensitivity/specificity) and A10 < 45 mm (96/95% sensitivity/specificity). TEG® FF optimal YI was at A5 < 12 mm (97/93% sensitivity/specificity) and A10 < 15 mm (97/99% sensitivity/specificity). In summary, we found that TEG® 6s early amplitudes were sensitive and specific predictors of MA in severely injured trauma patients. Intervening on early amplitudes can save valuable time in hemostatic resuscitation.

KW - Blood coagulation

KW - hemostasis

KW - shock

KW - thrombelastography

KW - trauma

U2 - 10.1080/00365513.2022.2119599

DO - 10.1080/00365513.2022.2119599

M3 - Journal article

C2 - 36073613

AN - SCOPUS:85138270514

VL - 82

SP - 508

EP - 512

JO - Scandinavian Journal of Clinical and Laboratory Investigation. Supplement

JF - Scandinavian Journal of Clinical and Laboratory Investigation. Supplement

SN - 0085-591X

IS - 6

ER -

ID: 329285495