Patent selection: bleeding patient
Parameters during the coagulation phase:
(1) time to start clot formation or reaction time (R), in minutes
(2) angle of clot formation (alpha), in degrees
(3) time to clot formation with maximum strength (K time), in minutes
(4) maximum amplitude of clot strength (MA), in mm
Parameters during the fibrinolytic phase:
(1) percent lysis at 30 minutes after maximum amplitude, in percent
|
Measurement
|
Finding
|
Therapy
|
|
reaction time
|
> ULN
|
FFP, Factor 7a, PCC
|
|
angle of clot formation
|
< LLN
|
cryoprecipitate, platelets
|
|
time to max strength
|
> ULN
|
cryoprecipitate, platelets
|
|
maximum amplitude
|
< LLN
|
cryoprecipitate, platelets
|
|
percent lysis 30 minutes
|
> ULN
|
fibrinolytics
|
where:
• PCC = prothrombin complex concentrate
• ULN = upper limit of normal, LLN = lower limit of normal
• Cryoprecipitate serves as a souce of fibrinogen.
