Thrombelastography is a useful method for the monitoring of bedside coagulation, especially for fibrinolysis. We report a case where thrombelastography facilitated early detection of fibrinolysis with significant clinical bleeding in a patient immediately following hip replacement surgery. The early diagnosis enabled institution of antifibrinolytic therapy and monitoring of the patient's response. It is likely to have led to less blood product transfusion and may possibly have prevented unnecessary surgical re-exploration.
KangY.G., MartinD.J., MarquezJ.M.. Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation. Anesth Analg1985; 64: 888–896.
2.
McNicolP.L., LiuG., HarleyI.D.. Patterns of coagulopathy during liver transplantation: experience with the first 75 cases using thrombelastography. Anaesth Intensive Care1994; 22: 659–665.
3.
Thrombelastograph® User Manual. Haemoscope Corporation 1999.
4.
ZuckermanL., CohenE., VagherJ.. Comparison of thrombelastography with common coagulation tests. Thromb Haemost1981; 46: 752–756.
5.
HowlandW., SchweizerO., GouldP.A comparison of intra-operative measurements of coagulation. Anesth Analg1974; 53: 657–663.
6.
SpiessB., TumanK., McCarthyR.. Thrombelastography as an indicator of post-cardiopulmonary bypass coagulopathies. J Clin Monit1987; 3: 25–30.
7.
KangY.G., LewisJ.H., NavalgundA.. Epsilon-aminocaproic acid for treatment of fibrinolysis during liver transplantation. Anesthesiology1987; 66: 766–773.
SummariaL., SandesaraJ., YangG.. In vitro comparison of fibrinolytic activity of plasminogen activators using a throm-belastographic method: in vitro evaluation of the B-chain-streptokinase complex in the dog model using pre-titred doses. Thromb Haemost1986; 56: 71–79.
10.
ButlerM.J.Thrombelastography during and after elective abdominal surgery. Thromb Haemost1978; 39: 488–495.
11.
TumanK.J., SpiessB.D., McCarthyR.J., IvankovichA.D.Effects of progressive blood loss on coagulation as measured by thrombe-lastography. Anesth Analg1987; 66: 856–863.
12.
StumpD.C., TaylorF.B., NesheinM.E.. Pathologic fib-rinolysis as a cause of clinical bleeding. Semin Thromb Haemost1990; 16: 260–273.
