Thrombodynamics test can adequate estimate hemostasis of burn patients and can help to predict thrombotic complications
59th Annual Meeting of the German, Austrian and Swiss Society of Thrombosis and Hemostasis Research (GTH) 2015, D?sseldorf, Germany
One of the most common complications of burn disease are thrombosis. To prevent pathologic blood clotting anticoagulants are used. Standard coagulation test (activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin (by Quick), international normalized ratio (INR), and fibrinogen concentration as inflammatory marker) are used to estimate hemostasis of burn patients. Sometimes standard diagnostic tests can't adequate characterize coagulation system status. This topic compares standard tests with a new global Thrombodynamics test (TD) for description of one clinical case. The patient H (75 years old, woman) had general burn 18% BSA (body surface area), deep burn 5% BSA. She received unfractionated heparin (20000 IU/day (four times using bolus dosing)). The hemostasis of patients was monitored for the all period of treatment from the arrival to the discharge. Besides standard coagulation test the hemostasis state of patient was monitored using TD. Parameters of standard tests (APTT, TT, PT, INR) were in normal range over all period of observation, and only fibrinogen concentration was not significantly increased (in the mean 4.5 g/l, while normal range is 1.8-3.5 g/l). On the 17-th day the fibrinogen concentration reached the value 7.1 g/l, and in two days decreased to 5.5 g/l. In the period from 12th till 17th day patient was additionally treated with antifibrinolytic drug (Gordox). The parameters of TD (Vst - stationary clot rate and Vin - initially clot rate) in one week before a surgical operation (11th day) were in normal range. Starting form 12th days TD showed hypercoagulation status (Vi varied from 58.2 to 61.4 µm/min, while normal range is 38-56 µm/min, and Vst was about 31 µm/min, while normal range is 20-29 µm/min). On the 20th day mural thrombosis of a sural vein was registrated using ultrasonography. We suppose that the TD test can be useful during analysis of coagulation status of burn patients and prediction of developing thrombosis.