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Thromboelastography to monitor clotting/bleeding complications in patients treated with the molecular adsorbent recirculating system.
- Source :
- Critical Care Research & Practice; 2011, p1-10, 10p, 2 Diagrams, 3 Charts, 4 Graphs
- Publication Year :
- 2011
-
Abstract
- Background. The Molecular Adsorbent Recirculating System (MARS) has been shown to clear albumin-bound toxins from patients with liver failure but might cause bleeding complications potentially obscuring survival benefits. We hypothesized that monitoring clotting parameters and bed-side thromboelastography allows to reduce bleeding complications. Methods. Retrospective analysis of 25 MARS sessions during which clotting parameters were monitored by a standardized protocol. Results. During MARS therapy median INR increased significantly from 1.7 to 1.9 platelet count and fibrinogen content decreased significantly from 57 fL(-1) to 42 fL(-1) and 2.1 g/L to 1.5 g/L. Nine relevant complications occurred: the MARS system clotted 6 times 3 times we observed hemorrhages. Absent thrombocytopenia and elevated plasma fibrinogen predicted clotting of the MARS system (ROC 0.94 and 0.82). Fibrinolysis, detected by thromboelastography, uniquely predicted bleeding events. Conclusion. Bed-side thromboelastography and close monitoring of coagulation parameters can predict and, therefore, help prevent bleeding complications during MARS therapy. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 20901305
- Database :
- Complementary Index
- Journal :
- Critical Care Research & Practice
- Publication Type :
- Academic Journal
- Accession number :
- 70697659
- Full Text :
- https://doi.org/10.1155/2011/313854