No Cover Image

Journal article 911 views 168 downloads

Measuring coagulation in burns: an evidence-based systematic review

Nicholas J. Marsden, Martin Van, Samera Dean, Ernest Azzopardi Orcid Logo, Sarah Hemington-Gorse, Phillip A. Evans, Iain S. Whitaker

Scars, Burns & Healing, Volume: 3, Start page: 205951311772820

Swansea University Author: Ernest Azzopardi Orcid Logo

  • scarsburnshealingmsd.pdf

    PDF | Version of Record

    Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License.

    Download (477.91KB)

Abstract

Measuring coagulation in burns: an evidence-based systematic reviewShow all authorsNicholas J. Marsden, Martin Van, Samera Dean, ...First Published September 5, 2017 Review Article Download PDFPDF download for Measuring coagulation in burns: an evidence-based systematic reviewArticle information Ope...

Full description

Published in: Scars, Burns & Healing
ISSN: 2059-5131 2059-5131
Published: 2017
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa40079
Tags: Add Tag
No Tags, Be the first to tag this record!
Abstract: Measuring coagulation in burns: an evidence-based systematic reviewShow all authorsNicholas J. Marsden, Martin Van, Samera Dean, ...First Published September 5, 2017 Review Article Download PDFPDF download for Measuring coagulation in burns: an evidence-based systematic reviewArticle information Open Access Creative Commons Attribution, Non Commercial 4.0 LicenseAbstractIntroduction:Dynamic monitoring of coagulation is important to predict both haemorrhagic and thrombotic complications and to guide blood product administration. Reducing blood loss and tailoring blood product administration may improve patient outcome and reduce mortality associated with transfusion. The current literature lacks a systematic, critical appraisal of current best evidence on which clinical decisions may be based.Objectives:Establishing the role of different coagulation markers in burn patients, diagnosing coagulopathy, tailoring blood product administration and indicating prognosis.Methods:Literature during 2004–2017 from the Cochrane Library, PubMed, Scopus, Medline and Embase was reviewed. Eligibility criteria included randomised controlled trials, systematic reviews, multi-/single-centre study and meta-analyses. Keywords searched were ‘burns’, ‘blood coagulation disorders’, ‘rotem’, ‘blood coagulation’ and ‘thromboelastography’. The PRISMA flow system was used for stratification and the CASP framework for appraisal of the studies retrieved.Results:In total, 13 articles were included after inclusion/exclusion criteria had been applied to the initial 79 studies retrieved. Hypercoagulation increases in proportion to the severity of thermal injury. Whole blood testing, using thrombelastography (TEG) and rotation thromboelastometry (ROTEM), was superior to standard plasma based tests, including prothrombin time (PT) and activated partial thromboplastin time (APTT) at detecting burn-related coagulopathies.Conclusions:Routine laboratory markers such as PT/APTT are poor indicators of coagulation status in burns patients. Viscoelastic tests, such as TEG and ROTEM, are efficient, fast and have a potential use in the management of burn patients; however, strong evidence is lacking. This review highlights the need for more randomised controlled trials, to guide future practice.
Keywords: Burns, clotting, coagulation tests, viscoelastic test, point-of-care, thrombelastography, rotation thromboelastometry
College: Faculty of Medicine, Health and Life Sciences
Start Page: 205951311772820