ĐẶC ĐIỂM RỐI LOẠN ĐÔNG CẦM MÁU BẰNG XÉT NGHIỆM ROTEM Ở BỆNH NHÂN SUY GAN CẤP

Abstract

Objective: to assess the characteristics of hemostatic disorders by thromboelastometry (ROTEM) in patients with acute liver failure. Subjects and methods: observational study included 52 patients with acute liver failure treated at Poison Control Center of Bach Mai hospital from 8/2018 to 7/2019. Results: Male accounted for 55.8%, mean age was 53.8 (19-87). In the INTEM and EXTEM channels, normal CT values were common (65.4% and 61.5%). In FIBTEM channel, CT value was mainly prolonged (63.5%). In the INTEM channel, the MCF was mostly normal (69.2%). The clot amplitudes in EXTEM and FIBTEM channels were mostly normal (67.3% and 73.1%) with only 1 case of increased clot amplitude in A5. On ROTEM, there was mainly hypocoagulation (59.61%), 11.53% were hypercoagulation, increased fibrinolysis accounted for 34.6%. The hypocoagulation status was caused by decreased endogenous and exogenous coagulation factors, decreased fibrinogen (34.6%, 36.5%, 38.5%), rarely due to platelet disorders (7.7%). Among patients with hypocoagulable status on ROTEM, the number of patients with multiple disorders accounted for a higher proportion (56.25%). Conclusion: ROTEM helps to evaluate in more details the complex hemostatic disorders in patients with acute liver failure.