Skip to main content
Top
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 12/2018

01-12-2018 | Editorials

Viscoelastic testing: It’s not the measurement, it’s what you do with it!

Author: Roman M. Sniecinski, MD, MSc

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 12/2018

Login to get access

Excerpt

“Measure what is measurable, and make measurable what is not so.” Galileo Galilei
Anesthesiologists love to measure things. Heart rate, blood pressure, and pulse oximetry values all provide information that aids in directing anesthetic care. In fact, these measurements are necessary to provide a safe anesthetic. Laboratory measurements also play a role in guiding therapy, albeit without the instant gratification of vital sign changes. For example, most practitioners would feel uncomfortable administering insulin to a patient without the ability to measure a blood glucose level at some point. Transfusion of blood products is a more complex issue, but one that also relies heavily on measurement—or at least it should. …
Literature
1.
go back to reference Society of Thoracic Surgeons Blood Conservation Guideline Task Force; Ferraris VA, Brown JR, Despotis GJ, et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 2011; 91: 944-82. Society of Thoracic Surgeons Blood Conservation Guideline Task Force; Ferraris VA, Brown JR, Despotis GJ, et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 2011; 91: 944-82.
2.
go back to reference Kozek-Langenecker SA, Ahmed AB, Afshari A, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016. Eur J Anaesthesiol 2017; 34: 332-95.CrossRef Kozek-Langenecker SA, Ahmed AB, Afshari A, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016. Eur J Anaesthesiol 2017; 34: 332-95.CrossRef
3.
go back to reference Task Force on Patient Blood Management for Adult Cardiac Surgery of the European Association for Cardio-Thoracic Surgery (EACTS); European Association of Cardiothoracic Anaesthesiology (EACTA); Boer C, Meesters MI, Milojevic M, et al. 2017 EACTS/EACTA guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth 2018; 32: 88-120. Task Force on Patient Blood Management for Adult Cardiac Surgery of the European Association for Cardio-Thoracic Surgery (EACTS); European Association of Cardiothoracic Anaesthesiology (EACTA); Boer C, Meesters MI, Milojevic M, et al. 2017 EACTS/EACTA guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth 2018; 32: 88-120.
6.
go back to reference Deppe AC, Weber C, Zimmermann J, et al. Point-of-care thromboelastography/thromboelastometry-based coagulation management in cardiac surgery: a meta-analysis of 8332 patients. J Surg Res 2016; 203: 424-33.CrossRef Deppe AC, Weber C, Zimmermann J, et al. Point-of-care thromboelastography/thromboelastometry-based coagulation management in cardiac surgery: a meta-analysis of 8332 patients. J Surg Res 2016; 203: 424-33.CrossRef
7.
go back to reference Serraino GF, Murphy GJ. Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis. Br J Anaesth 2017; 118: 823-33.CrossRef Serraino GF, Murphy GJ. Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis. Br J Anaesth 2017; 118: 823-33.CrossRef
8.
go back to reference Ak K, Isbir CS, Tetik S, et al. Thromboelastography-based transfusion algorithm reduces blood product use after elective CABG: a prospective randomized study. J Card Surg 2009; 24: 404-10.CrossRef Ak K, Isbir CS, Tetik S, et al. Thromboelastography-based transfusion algorithm reduces blood product use after elective CABG: a prospective randomized study. J Card Surg 2009; 24: 404-10.CrossRef
9.
go back to reference Avidan MS, Alcock EL, Da Fonseca J, et al. Comparison of structured use of routine laboratory tests or near-patient assessment with clinical judgement in the management of bleeding after cardiac surgery. Br J Anaesth 2004; 92: 178-86.CrossRef Avidan MS, Alcock EL, Da Fonseca J, et al. Comparison of structured use of routine laboratory tests or near-patient assessment with clinical judgement in the management of bleeding after cardiac surgery. Br J Anaesth 2004; 92: 178-86.CrossRef
10.
go back to reference Girdauskas E, Kempfert J, Kuntze T, et al. Thromboelastometrically guided transfusion protocol during aortic surgery with circulatory arrest: a prospective, randomized trial. J Thorac Cardiovasc Surg 2010; 140(1117-24): e2. Girdauskas E, Kempfert J, Kuntze T, et al. Thromboelastometrically guided transfusion protocol during aortic surgery with circulatory arrest: a prospective, randomized trial. J Thorac Cardiovasc Surg 2010; 140(1117-24): e2.
11.
go back to reference Karkouti K, Callum J, Wijeysundera DN, et al. Point-of-care hemostatic testing in cardiac surgery: a stepped-wedge clustered randomized controlled trial. Circulation 2016; 134: 1152-62.CrossRef Karkouti K, Callum J, Wijeysundera DN, et al. Point-of-care hemostatic testing in cardiac surgery: a stepped-wedge clustered randomized controlled trial. Circulation 2016; 134: 1152-62.CrossRef
12.
go back to reference Kultufan Turan S, Ayik I, Yagar S, Kazanci D, Karadeniz U, Ozgok A, Erdemli O. The role of rotaitonal thromboelastography on decision of blood transfusion in open heart surgery. GKD Anest Yoj Bak Dem Ders 2006; 12: 154-9. Kultufan Turan S, Aydinli B, Ayik I, et al. The role of rotational thromboelastography on decision of blood transfusion in open heart surgery; 2006; 12: 154. Kultufan Turan S, Ayik I, Yagar S, Kazanci D, Karadeniz U, Ozgok A, Erdemli O. The role of rotaitonal thromboelastography on decision of blood transfusion in open heart surgery. GKD Anest Yoj Bak Dem Ders 2006; 12: 154-9. Kultufan Turan S, Aydinli B, Ayik I, et al. The role of rotational thromboelastography on decision of blood transfusion in open heart surgery; 2006; 12: 154.
13.
go back to reference Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA. Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg 1999; 88: 312-9.PubMed Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA. Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg 1999; 88: 312-9.PubMed
14.
go back to reference Weber CF, Görlinger K, Meininger D, et al. Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology 2012; 117: 531-47.CrossRef Weber CF, Görlinger K, Meininger D, et al. Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology 2012; 117: 531-47.CrossRef
15.
go back to reference Adler M, Ivic S, Bodmer DS, et al. Thromboelastometry and thrombelastography analysis under normal physiological conditions - systematic review. Transfus Med Hemother 2017; 44: 78-83.CrossRef Adler M, Ivic S, Bodmer DS, et al. Thromboelastometry and thrombelastography analysis under normal physiological conditions - systematic review. Transfus Med Hemother 2017; 44: 78-83.CrossRef
Metadata
Title
Viscoelastic testing: It’s not the measurement, it’s what you do with it!
Author
Roman M. Sniecinski, MD, MSc
Publication date
01-12-2018
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 12/2018
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-018-1218-8

Other articles of this Issue 12/2018

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 12/2018 Go to the issue