Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-59745
Bachli, E B; Bösiger, J; Béchir, M; Stover, J F; Stocker, R; Maggiorini, M; Renner, E L; Müllhaupt, B; Schuepbach, R A (2011). Thromboelastography to monitor clotting/bleeding complications in patients treated with the molecular adsorbent recirculating system. Critical Care Research and Practice, 2011:313854.
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.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Research|
04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Intensive Care Medicine
|DDC:||610 Medicine & health|
|Deposited On:||26 Feb 2012 10:30|
|Last Modified:||10 Dec 2012 10:16|
|Publisher:||Hindawi Publishing Corporation|
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