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Interpretation of thromboelastometry tracings

Created: 1/9/2005
 


Clotting time (CT) or reaction time( R time)

The time from the start of the curve until it reaches 1 mm wide
This is the time taken to form fibrin. Prolonged with clotting factor deficiencies, anticoagulants and thrombocytopaenia.

Clot formation time (CFT) or K time

The time taken for the graph to widen from 1 mm to 20 mm. This is dependent on fibrinogen and platelets.

Maximum clot firmness (MCF )or maximum amplitude

This is the width of the curve at the widest point. This is affected by platelet function and number and fibrinogen.

Alpha angle

This is the angle measured between the midline of the tracing and a line drawn from the 1 mm point tangential to the curve.

The alpha value and CFT indicate the rate of increase of elastic shear modulus in the sample – i.e. how fast the clot structure is forming.

This is abnormal in the presence of clotting factor deficiencies, platelet dysfunction, thrombocytopenia and hypofibrinogenaemia.

Fibrinolysis

This is measured as a decrease in amplitude from the maximum. If there is a substantial decrease – i.e. more than 15% – then this is an indication of fibrinolysis taking place.

Advantages of thromboelastometry

 Real time production of a trace
 Heparinase modification allows the diagnosis of excess heparin as a cause of long R time.
 Fibrinolysis may be demonstrated by the lysis times at 30 and 60 minutes.
 A normal trace in a bleeding patient suggests a surgical source.
 Repeated tests can monitor the progress of intervention.


ArticleDate:20050901
SiteSection: Article
 
   
    
                                            
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