Accession Number : ADA627609


Title :   Thromboelastography to Direct the Administration of Recombinant Activated Factor VII in a Child with Traumatic Injury Requiring Massive Transfusion


Descriptive Note : Journal article


Corporate Author : ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX


Personal Author(s) : Nylund, Cade M ; Borgman, Matthew A ; Holcomb, John B ; Jenkins, Donald ; Spinella, Philip C


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a627609.pdf


Report Date : Jan 2009


Pagination or Media Count : 6


Abstract : Objective: To describe the use of thromboelastography (TEG) to direct hemostatic resuscitation in a child with traumatic injury requiring massive transfusion. Design: Case report. Setting: Level 1 pediatric trauma center in an academic tertiary care facility. Patient: A 5-year-old boy with grade IV liver injury and right common hepatic artery laceration. Intervention: TEG-directed resuscitation, including recombinant activated factor VII. Measurements and Main Results: Measurements included vital signs, laboratory results to include TEG values, and blood product administration. TEG-directed resuscitation with recombinant activated factor VII was associated with the prevention of increased intracranial hemorrhage and survival in a coagulopathic patient with a life-threatening traumatic injury. Conclusion: Our clinical and TEG laboratory results postesuscitation support the potential use of TEG as a tool to direct hemostatic resuscitation in patients with severe trauma requiring massive transfusion. TEG is a quick and focused method of qualitatively assessing the entire coagulation cascade, from clot formation to fibrinolysis that permits a targeted transfusion approach to the treatment of coagulopathy. TEG has the potential to rapidly and effectively direct hemostatic resuscitation in patients with the coagulopathy of trauma.


Descriptors :   *BLOOD TRANSFUSION , *CHILDREN , *HEMORRHAGE , *RESUSCITATION , *TRAUMA , *WOUNDS AND INJURIES , BLOOD CELLS , BLOOD COAGULATION , CASE STUDIES , CLINICAL MEDICINE , EMBOLISM , INTENSIVE CARE UNITS , LIVER , PATIENTS , PEDIATRICS , PHYSIOLOGICAL EFFECTS , PREVENTION , RESPONSE(BIOLOGY) , SIGNS AND SYMPTOMS , SKULL , THROMBOSIS , VITAL SIGNS


Subject Categories : Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE