ÁP DỤNG PHƯƠNG PHÁP ĐO ĐÀN HỒI CỤC MÁU (ROTEM) ĐỂ ĐÁNH GIÁ TÌNH TRẠNG RỐI LOẠN ĐÔNG MÁU Ở BỆNH NHÂN NHIỄM KHUẨN HUYẾT CÓ THỜI GIAN PROTHROMBIN VÀ THỜI GIAN THROMBOPLASTIN HOẠT HÓA TỪNG PHẦN KÉO DÀI

Abstract

Objectives: Comparison of coagulation status based on rotational thromboelastometry (ROTEM) in patients with sepsis with INR >1.2 or aPTTr >1.2 in the survivor group and non-survivor group admission to the intensive care unit. Subjects and methods: A cross-sectional study of patients with sepsis with INR >1.2 or aPTTr >1.2 admitted to the Intensive Care Unit of the University Medical Centre of Ho Chi Minh City from June 2020 to December 2021 was performed. Results: 95 patients were included from 161 patients with sepsis in the original study. The median age was 70 [61-80] and SOFA score was 7 [5-9]. The in-hospital mortality rate was 25.3%. The median INR and aPTTr were 1.42 [1.3-1.65] and 1.12 [4.1-6.8], respectively. Non-survivors had lower fibrinogen levels, higher blood lactate levels, and higher INR than the survivors, with p <0.05. The proportions of hypocoagulation, hypercoagulation, and normal coagulation on ROTEM in patients with INR >1.2 were 58.2%, 26.4%, and 29.7%, respectively. The proportions of hypocoagulation, hypercoagulation, and normal coagulation on ROTEM in patients with aPTTr >1.2 were 65.7%, 14.3%, and 28.6%, respectively. Hypocoagulation on ROTEM increased the mortality rate, but the difference was not statistically significant (p >0.05). Conclusion: Patients with sepsis or septic shock with prolonged INR or aPTTr may have hypercoagulation or normal coagulation based on ROTEM.