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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Hildegardis Dyna Dumilah
Department of Clinical Pathology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The mostcommon complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangeroushypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict futurehemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited todetect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) providesan overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was takenand tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100idevice. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room.Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The resultsshowed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleedingvolume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, andLY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%,which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEGis more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.
TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The most common complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangerous hypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict future hemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited to detect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) provides an overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was taken and tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100i device. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room. Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The results showed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleeding volume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, and LY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%, which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEG is more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.  
Co-Authors Arifoel Hajat Hartono Kahar, Hartono Heroe Soebroto Philia Setiawan