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Master Thesis

Complications thrombo-emboliques du traumatisé crânien grave‎ : intérêt de la thromboélastométrie

Abstract : Introduction: Traumatic brain injured (TBI) patients are at high risk of thromboembolic events (TE) as deep vein thrombosis (DVT) and pulmonary embolism (PE). There is no consensual recommendations about prevention and treatment of TE in this population at high risk of intracranial hemorrhage. Hypercoagulability is not properly defined by usual clinical and biological data and thromboelastometry can be an alternative. Materials: We prospectively studied TE and evolution of usual clinico-biological and thromboelastometric (ROTEM) data in severe TBI patients. The follow-up included a daily clinical examination, classical and thromboelastometric blood samplings on H0, H12, H24, D7, D14 and D28 combined with a weekly venous ultrasound test to investigate TE. Results: Diagnosis of TE was done in 13% of the 93 patients included in the study(6 DVT, 6 PE). Median onset of TE was 11 days (14 days for DVT, 6 days for PE) with a median delay of anticoagulation onset of 6,5days. There was no significant difference between TE+ and TE- patients in terms of usual nor thromboelastometric tests but thromboelastometric data analysis showed an increase of maximal clot firmness with apparition of a hypercoagulable profile on D7. Conclusion: Thromboelastometry associated to usual biological tests can provide informative data on early hypercoagulable state diagnosis and help the clinician in anticoagulation onset decision in severe TBI patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00813084
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Submitted on : Monday, April 15, 2013 - 8:58:13 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
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Julie Bardon. Complications thrombo-emboliques du traumatisé crânien grave‎ : intérêt de la thromboélastométrie. Médecine humaine et pathologie. 2013. ⟨dumas-00813084⟩

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