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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

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DOI (Published version): 10.1177/2059513117728201

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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...

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Published in: Scars, Burns & Healing
ISSN: 2059-5131 2059-5131
Published: 2017
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URI: https://cronfa.swan.ac.uk/Record/cronfa40079
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2018-06-01T12:14:11.6899058</datestamp><bib-version>v2</bib-version><id>40079</id><entry>2018-05-10</entry><title>Measuring coagulation in burns: an evidence-based systematic review</title><swanseaauthors><author><sid>085180eab0379efceb426fa9990ba928</sid><ORCID>0000-0002-4511-0954</ORCID><firstname>Ernest</firstname><surname>Azzopardi</surname><name>Ernest Azzopardi</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2018-05-10</date><deptcode>PMSC</deptcode><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&#x2013;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 &#x2018;burns&#x2019;, &#x2018;blood coagulation disorders&#x2019;, &#x2018;rotem&#x2019;, &#x2018;blood coagulation&#x2019; and &#x2018;thromboelastography&#x2019;. 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.</abstract><type>Journal Article</type><journal>Scars, Burns &amp; Healing</journal><volume>3</volume><paginationStart>205951311772820</paginationStart><publisher/><issnPrint>2059-5131</issnPrint><issnElectronic>2059-5131</issnElectronic><keywords>Burns, clotting, coagulation tests, viscoelastic test, point-of-care, thrombelastography, rotation thromboelastometry</keywords><publishedDay>5</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-09-05</publishedDate><doi>10.1177/2059513117728201</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2018-06-01T12:14:11.6899058</lastEdited><Created>2018-05-10T00:16:22.2971499</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Nicholas J.</firstname><surname>Marsden</surname><order>1</order></author><author><firstname>Martin</firstname><surname>Van</surname><order>2</order></author><author><firstname>Samera</firstname><surname>Dean</surname><order>3</order></author><author><firstname>Ernest</firstname><surname>Azzopardi</surname><orcid>0000-0002-4511-0954</orcid><order>4</order></author><author><firstname>Sarah</firstname><surname>Hemington-Gorse</surname><order>5</order></author><author><firstname>Phillip A.</firstname><surname>Evans</surname><order>6</order></author><author><firstname>Iain S.</firstname><surname>Whitaker</surname><order>7</order></author></authors><documents><document><filename>0040079-10052018001731.pdf</filename><originalFilename>scarsburnshealingmsd.pdf</originalFilename><uploaded>2018-05-10T00:17:31.6570000</uploaded><type>Output</type><contentLength>464252</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2018-05-10T00:00:00.0000000</embargoDate><documentNotes>Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2018-06-01T12:14:11.6899058 v2 40079 2018-05-10 Measuring coagulation in burns: an evidence-based systematic review 085180eab0379efceb426fa9990ba928 0000-0002-4511-0954 Ernest Azzopardi Ernest Azzopardi true false 2018-05-10 PMSC 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. Journal Article Scars, Burns & Healing 3 205951311772820 2059-5131 2059-5131 Burns, clotting, coagulation tests, viscoelastic test, point-of-care, thrombelastography, rotation thromboelastometry 5 9 2017 2017-09-05 10.1177/2059513117728201 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2018-06-01T12:14:11.6899058 2018-05-10T00:16:22.2971499 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Nicholas J. Marsden 1 Martin Van 2 Samera Dean 3 Ernest Azzopardi 0000-0002-4511-0954 4 Sarah Hemington-Gorse 5 Phillip A. Evans 6 Iain S. Whitaker 7 0040079-10052018001731.pdf scarsburnshealingmsd.pdf 2018-05-10T00:17:31.6570000 Output 464252 application/pdf Version of Record true 2018-05-10T00:00:00.0000000 Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License. true eng
title Measuring coagulation in burns: an evidence-based systematic review
spellingShingle Measuring coagulation in burns: an evidence-based systematic review
Ernest Azzopardi
title_short Measuring coagulation in burns: an evidence-based systematic review
title_full Measuring coagulation in burns: an evidence-based systematic review
title_fullStr Measuring coagulation in burns: an evidence-based systematic review
title_full_unstemmed Measuring coagulation in burns: an evidence-based systematic review
title_sort Measuring coagulation in burns: an evidence-based systematic review
author_id_str_mv 085180eab0379efceb426fa9990ba928
author_id_fullname_str_mv 085180eab0379efceb426fa9990ba928_***_Ernest Azzopardi
author Ernest Azzopardi
author2 Nicholas J. Marsden
Martin Van
Samera Dean
Ernest Azzopardi
Sarah Hemington-Gorse
Phillip A. Evans
Iain S. Whitaker
format Journal article
container_title Scars, Burns & Healing
container_volume 3
container_start_page 205951311772820
publishDate 2017
institution Swansea University
issn 2059-5131
2059-5131
doi_str_mv 10.1177/2059513117728201
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description 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.
published_date 2017-09-05T03:51:00Z
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