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2020, vol. 71, br. 4, str. 3-9
Klinički značaj primene rotacione tromboelastometrije u detekciji poremećaja hemostaze
Univerzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za hematologiju, Beograd

e-adresansabljic19@gmail.com
Ključne reči: koagulopatija; rotaciona tromboelastometrija; sepsa; trauma; maligniteti
Sažetak
Hemostaza predstavlja ravnotežu između prokoagulantnih i antikoagulantnih procesa i, jednom narušena, vodi do koagulopatije u vidu krvarenja ili tromboze. Mnoga stanja mogu da uzrokuju koagulopatiju, ali su najčešća sepsa, trauma i maligniteti. Široko primenjivani konvencionalni koagulacioni testovi (KKT) primarno se koriste za detekciju hipokoagulabilnosti i fokusiraju se samo na inicijaciju procesa koagulacije. Viskoelastografski testovi (VET), kao što je rotaciona tromboelastometrija (ROTEM), testovi su iz pune krvi kojima mogu da se detektuju poremećaji u različitim fazama koagulacije, počevši od inicijacije, preko elongacije i propagacije, pa sve do lize ugruška, te mogu da ukažu i na hipoi na hiperkoagulabilnost. Rotaciona tromboelastometrija se široko primenjuje kod pacijenata sa traumom i u velikim hirurškim intervencijama kao sredstvo na osnovu čijih rezultata se određuje potreba za primenom transfuzijskih mera. Nekoliko studija, sprovedenih na pacijentima sa sepsom, pokazalo je da je hipokoagulabilan ROTEM obrazac prediktor loše prognoze. S druge strane, danas postoji veliki interes za primenu ROTEM-a u malignitetima. Rezultati dosadašnjih studija ukazali su da je na osnovu ROTEM-a moguće identifikovati pacijenta u povećanom riziku za razvoj tromboembolijskih komplikacija. Biće neophodna dodatna istraživanja i randomizovane studije da bi se potvrdili značaj i uloga ROTEM-a i pomoglo u donošenju konsenzusa o njegovoj primeni u različitim oblastima medicine.
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O članku

jezik rada: engleski
vrsta rada: pregledni članak
DOI: 10.5937/mp71-27853
objavljen u SCIndeksu: 12.05.2021.
metod recenzije: dvostruko anoniman
Creative Commons License 4.0