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Aktuelle Gerinnungsdiagnostik in der Intensivmedizin

Current coagulation diagnostics in intensive care medicine

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Zusammenfassung

Im präoperativen Bereich kann die standardisierte Blutungsanamnese nicht durch Quick-Test und die aktivierte partielle Thromboplastinzeit (aPTT) ersetzt werden. Im intra- und postoperativen Bereich eröffnet die Thrombelastometrie die Möglichkeit einer patientennahen und zielgerichteten Gerinnungstherapie. Im Gegensatz zur quantitativen Bestimmung von Fibrinogen und Thrombozyten, kann durch die Thrombelastometrie auch das funktionelle Zusammenspiel zwischen den Gerinnungsfaktoren und den Thrombozyten im Sinne der Clotfestigkeit und -stabilität erfassen. Durch eine zielgerichtete Komponententherapie kann nicht nur der Verbrauch von Blutprodukten vermindert werden, man kann zudem mit einem verkürzten Aufenthalt sowohl auf der Intensiv- als auch auf der Normalstation rechnen. Dies führt zu einer erheblichen Kosteneinsparung.

Abstract

In the preoperative setting, a standardized questionnaire on bleeding history cannot be replaced by the Quick test or activated partial thromboplastin time (APTT) measurement. Thrombelastometry provides rapid measurement of coagulation in the intra- and postoperative settings. Besides the Quick test and APTT, thrombelastometry provides information about clot firmness and clot stability. This allows goal-directed management in coagulopathy, which results in a reduction of transfusion of blood products. Furthermore, this can lead to not only an overall reduced length of stay in the hospital, but also in the intensive care unit, thus, contributing to a significant cost reduction.

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  1. Gerinnungsambulanz Südheide, Tiergarten 2, 29362, Hohne, Deutschland

    T. Lang

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Lang, T. Aktuelle Gerinnungsdiagnostik in der Intensivmedizin. Med Klin 106, 171–176 (2011). https://doi.org/10.1007/s00063-011-0018-5

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