대한수혈학회지 (The Korean Journal of Blood Transfusion)

  • 제29권3호
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  • Pages.240-252
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  • 2018
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  • 1226-9336(pISSN)
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  • 2383-6881(eISSN)
대한수혈학회 (The Korean Society of Blood Transfusion)
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수혈 감소 전략을 위한 점탄성 응고 검사법의 유용성

Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions

  • 박선영 (순천향대학교 서울병원 마취통증의학과)
  • Park, Sun Young (Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital)
  • 투고 : 2018.10.22
  • 심사 : 2018.11.26
  • 발행 : 2018.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

점탄성 응고 검사법은 전혈 검사법으로 혈장성분뿐 아니라 응고 과정의 세포 기반 측면까지 동시에 볼 수 있는 방법이다. 프로트롬빈시간이나 활성화부분트롬보플라스틴시간과 같은 기존의 응고 검사법과 달리 이 검사는 현장 현시 검사로 즉시 시행할 수 있다. 점탄성 응고 검사법은 사망률 등의 예후 예측 인자이고, 응고 장애를 좀 더 예민하게 감지하여 결과적으로 출혈을 줄여주는 효과를 줄 수 있다. 점탄성 응고 검사 결과를 이용한 수혈 전략이 수혈 요구량을 줄여주었다고 보고되기도 하였다. 아직 이 방법의 정확성과 신뢰도에 대한 우려가 있기도 하지만, ROTEM 등의 점탄성 응고 검사법은 환자혈액관리에 응용하는 것은 유용할 것이다.

Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.

키워드

참고문헌

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