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Master Thesis

Exploration par thromboélastométrie de l'hémostase du traumatisé crânien à risque d'aggravation hémorragique

Abstract : Objectives : Description of thromboelastometric (ROTEM®) parameters during the initial stage of isolated traumatic brain injury (TBI) and their association with cerebral tomodensitometric (cTDM) hemorrhage progression. Material and methods : 93 patients were included after a recent (<8h), severe isolated (Non-Head AIS <3) TBI from October,2010 to March,2013. They all underwent a cTDM at admission and 24 hours later. Clinical examination, standard biological analysis and ROTEM® measurements were performed at admission, H12 and H24. Hemorrhage progression was defined as apparition of a new lesion, or increase in size of at least 30% of a pre-existing lesion, measured with the ABC/2 technique. Results : 29 patients presented hemorrhage progression on the control cTDM. Head-AIS and IGS2 were significativelly higher and initial brain lesions more severe for these patients. Presence of subarachnoïdal hemorrhage on the first cTDM was significativelly associated with hemorrhage progression. Although it stayed in normal ranges, there was a difference between the 2 groups in term of platelet level, fibrinogen and aPTT at admission. There was also a difference on ROTEM parameters MCF and A10 between the two groups, particularly at H12, and persistant after multivariate analysis, adjusted with Age, Head-AIS and Platelet level : a lower value of these parameters was associated with hemorrhage progression.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00826498
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Submitted on : Monday, May 27, 2013 - 4:02:40 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
Long-term archiving on: : Tuesday, April 4, 2017 - 11:32:08 AM

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  • HAL Id : dumas-00826498, version 1

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Lucie Gaide-Chevronnay. Exploration par thromboélastométrie de l'hémostase du traumatisé crânien à risque d'aggravation hémorragique. Médecine humaine et pathologie. 2013. ⟨dumas-00826498⟩

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