Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury

A unique coagulopathy often manifests following traumatic brain injury, leading the clinician down a difficult decision path on appropriate prophylaxis and therapy. Conventional coagulation assays—such as prothrombin time, partial thromboplastin time, and international normalized ratio—have historic...

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Autores principales:	Jamie L. Bradbury, Scott G. Thomas, Nikki R. Sorg, Nicolas Mjaess, Margaret R. Berquist, Toby J. Brenner, Jack H. Langford, Mathew K. Marsee, Ashton N. Moody, Connor M. Bunch, Sandeep R. Sing, Mahmoud D. Al-Fadhl, Qussai Salamah, Tarek Saleh, Neal B. Patel, Kashif A. Shaikh, Stephen M. Smith, Walter S. Langheinrich, Daniel H. Fulkerson, Sherry Sixta
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	adenosine diphosphate arachidonic acid blood platelets brain injuries traumatic cerebral hemorrhage Medicine R
Acceso en línea:	https://doaj.org/article/8ef354478256474da1db45dd610ef438
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spelling	oai:doaj.org-article:8ef354478256474da1db45dd610ef4382021-11-11T17:39:34ZViscoelastic Testing and Coagulopathy of Traumatic Brain Injury10.3390/jcm102150392077-0383https://doaj.org/article/8ef354478256474da1db45dd610ef4382021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5039https://doaj.org/toc/2077-0383A unique coagulopathy often manifests following traumatic brain injury, leading the clinician down a difficult decision path on appropriate prophylaxis and therapy. Conventional coagulation assays—such as prothrombin time, partial thromboplastin time, and international normalized ratio—have historically been utilized to assess hemostasis and guide treatment following traumatic brain injury. However, these plasma-based assays alone often lack the sensitivity to diagnose and adequately treat coagulopathy associated with traumatic brain injury. Here, we review the whole blood coagulation assays termed viscoelastic tests and their use in traumatic brain injury. Modified viscoelastic tests with platelet function assays have helped elucidate the underlying pathophysiology and guide clinical decisions in a goal-directed fashion. Platelet dysfunction appears to underlie most coagulopathies in this patient population, particularly at the adenosine diphosphate and/or arachidonic acid receptors. Future research will focus not only on the utility of viscoelastic tests in diagnosing coagulopathy in traumatic brain injury, but also on better defining the use of these tests as evidence-based and/or precision-based tools to improve patient outcomes.Jamie L. BradburyScott G. ThomasNikki R. SorgNicolas MjaessMargaret R. BerquistToby J. BrennerJack H. LangfordMathew K. MarseeAshton N. MoodyConnor M. BunchSandeep R. SingMahmoud D. Al-FadhlQussai SalamahTarek SalehNeal B. PatelKashif A. ShaikhStephen M. SmithWalter S. LangheinrichDaniel H. FulkersonSherry SixtaMDPI AGarticleadenosine diphosphatearachidonic acidblood plateletsbrain injuriestraumaticcerebral hemorrhageMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5039, p 5039 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adenosine diphosphate arachidonic acid blood platelets brain injuries traumatic cerebral hemorrhage Medicine R
spellingShingle	adenosine diphosphate arachidonic acid blood platelets brain injuries traumatic cerebral hemorrhage Medicine R Jamie L. Bradbury Scott G. Thomas Nikki R. Sorg Nicolas Mjaess Margaret R. Berquist Toby J. Brenner Jack H. Langford Mathew K. Marsee Ashton N. Moody Connor M. Bunch Sandeep R. Sing Mahmoud D. Al-Fadhl Qussai Salamah Tarek Saleh Neal B. Patel Kashif A. Shaikh Stephen M. Smith Walter S. Langheinrich Daniel H. Fulkerson Sherry Sixta Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
description	A unique coagulopathy often manifests following traumatic brain injury, leading the clinician down a difficult decision path on appropriate prophylaxis and therapy. Conventional coagulation assays—such as prothrombin time, partial thromboplastin time, and international normalized ratio—have historically been utilized to assess hemostasis and guide treatment following traumatic brain injury. However, these plasma-based assays alone often lack the sensitivity to diagnose and adequately treat coagulopathy associated with traumatic brain injury. Here, we review the whole blood coagulation assays termed viscoelastic tests and their use in traumatic brain injury. Modified viscoelastic tests with platelet function assays have helped elucidate the underlying pathophysiology and guide clinical decisions in a goal-directed fashion. Platelet dysfunction appears to underlie most coagulopathies in this patient population, particularly at the adenosine diphosphate and/or arachidonic acid receptors. Future research will focus not only on the utility of viscoelastic tests in diagnosing coagulopathy in traumatic brain injury, but also on better defining the use of these tests as evidence-based and/or precision-based tools to improve patient outcomes.
format	article
author	Jamie L. Bradbury Scott G. Thomas Nikki R. Sorg Nicolas Mjaess Margaret R. Berquist Toby J. Brenner Jack H. Langford Mathew K. Marsee Ashton N. Moody Connor M. Bunch Sandeep R. Sing Mahmoud D. Al-Fadhl Qussai Salamah Tarek Saleh Neal B. Patel Kashif A. Shaikh Stephen M. Smith Walter S. Langheinrich Daniel H. Fulkerson Sherry Sixta
author_facet	Jamie L. Bradbury Scott G. Thomas Nikki R. Sorg Nicolas Mjaess Margaret R. Berquist Toby J. Brenner Jack H. Langford Mathew K. Marsee Ashton N. Moody Connor M. Bunch Sandeep R. Sing Mahmoud D. Al-Fadhl Qussai Salamah Tarek Saleh Neal B. Patel Kashif A. Shaikh Stephen M. Smith Walter S. Langheinrich Daniel H. Fulkerson Sherry Sixta
author_sort	Jamie L. Bradbury
title	Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
title_short	Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
title_full	Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
title_fullStr	Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
title_full_unstemmed	Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
title_sort	viscoelastic testing and coagulopathy of traumatic brain injury
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8ef354478256474da1db45dd610ef438
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Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury

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