№ 6 / 2014 / 61-66

Application of low-frequency piezoelectric thromboelastography for assessing hemostatic potential of the blood in patients with idiopathic scoliosis

Author: Lebedeva M.N.¹, Tereshchenkova E.V.², Tyutrin I.I.³, Ageenko A.M.⁴, Ivanova A.A⁵

Abstract

The objective of the study was to assess hemostatic potential in 29 patients with idiopathic scoliosis using low-frequency piezoelectric trhromboelastography. The study was performed using hardware-software complex ARP-01M «MEDNORD» registering changes of the blood’s aggregative state and expressing them as thromboelastogram. Two types of the state of hemostatic potential were detected which are significantly different in terms of intraoperative blood loss. Twenty six patients had hypocoagulable type with changes in all stages of fibrinogenesis. Three patients had hypercoagulable type characterized by intravascular activation of blood coagulation, increased thrombin activity, and marked activation of anticoagulation. The method of low-frequency piezoelectric thromboelastography can serve as the predictor of the expected blood loss volume during surgical correction of scoliosis.

Key words

hemostasis, idiopathic scoliosis, blood loss, piezoelectric thromboelastography, surgical correction of scoliosis,

References

1. Barkagan ZS, Momot AP. Diagnosis and controlled therapy of hemostatic disorders. 2nd rev. and ext. ed. Moscow: Nyudiamed, 2001. 296 p. (in Russian)

2. Zaidman A.M., Korel A.V., Novikov V.V., Mikhailovsky M.V. The etiology and pathogenesis of II–IV grade idiopathic scoliosis // Spine Surgery – Full Spectrum: Proc. Sci. Conf dedicated to the 40^th Anniversary of CITO's Spine Pathology Department. Moscow, 2007. 185–186.(in Russian)

3. Kalashnikova E.V., Ekimov V.M., Krivov V.A. The blood loss dependence on the type of surgical correction and hemostatic disorders in patients with dysplastic scoliosis // Problems of the Spine and Spinal Сord Surgery: Proc. All-Russian Sci. Pract. Conf. Novosibirsk, 1996. 83–84. (in Russian)

4. Kalashnikova E.V., Sukhanova G.A., Buevich E.I. et al. Hemostasis system derangement and bleeding genesis in dysplastic scoliosis // Gematologiya i transfuziologiya. 1993. 38. (9). 15–19. (in Russian)

5. Lebedeva M.N., Ageenko A.M., Novikov V.V. et al. Retrospective analysis of intraoperative blood loss during surgery for idiopathic scoliosis // Khirurgiya povonochnika. (2). 70–78.(in Russian)

6. Mikhailovsky M.V., Fomichev N.G. Surgery of spinal deformities. Novosibirsk, 2011. 592 p. (in Russian)

7. Tyutrin I.I., Udut V.V., Shpisman M.N. Low-frequency piezoelectric thromboelastography in diagnosing hemostatic disorders (Guidelines). Tomsk: Mednord-Tekhnika, 2013. 67 p. (in Russian)

8. Tyutrin I.I., Klimenkova V.F., Udut V.V. A new technology for evaluating pharmacodynamics of antiaggregants // Eksperimental'naya i klinicheskaya farmakologiya. 2014. (2). 21–25. (in Russian)

9. Tyutrin I.I., Udut V.V., Klimenkova V.F. Functional state of hemostasis in pregnant women according to the "global" test of NPTEG // Patologicheskaya fiziologiya i experimental'naya terapiya. 2014. (2). 16–20. (in Russian)

10. Yakovlev V.M., Karpov R.S., Bakulina E.G. Connective tissue dysplasia of the bone tissue. Tomsk: STT, 2004. 104 p. (in Russian)

11. Bowen R.E., Gardner S., Scaduto A.A. et al. Efficacy of intraoperative cell salvage systems in pediatric idiopathic scoliosis patients undergoing posterior spinal fusion with segmental spinal instrumentation // Spine. 2010. 35. 246–251.

12. Ialenti M.N., Lonner B.S., Verma K. et al. Predicting operative blood loss during spinal fusion for adolescent idiopathic scoliosis // J. Pediatr. Orthop. 2013. 33. (4). 372–376.

13. Lipe B., Ornstein D.L. Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin // Circulation. 2011. 124. 365–368.

14. Mooney J.F., Barfield W.R. Validity of estimates of intraoperative blood loss in pediatric spinal deformity surgery // J. Spine Deformity. 2013. 1. 21–24.

15. Rau J.C., Beaulieu L.M., Huntington J.A., Church F.C. Serpins in thrombosis, hemostasis and fibrinolysis // J. Thromb. Haemost. 2007. 5 (1). 102–115.

16. Ryan K.M., O’Brien K., Regan I. et al. The prevalence of abnormal preoperative coagulation tests in pediatric patients undergoing spinal surgery for scoliosis // Spine J. 2013. pii S1529-9430(13)01381-8 2013.

17. Verma K., Lonner B., Dean L. et al. Reduction of mean arterial pressure at incision reduces blood loss in adolescent idiopathic scoliosis // Spine Deformity. 2013. 1. 115–122.

About Authors (Correspondence):

Lebedeva M.N. – doctor of medical sciences, chief researcher of the department of anesthesiology and intensive care, e-mail: MLebedeva@niito.ru

Tereshchenkova E.V. – candidate of medical sciences, physician of the department of anesthesiology and intensive care

Tyutrin I.I. – doctor of medical sciences, professor of the department of anesthesiology and intensive care

Ageenko A.M. – candidate of medical sciences, head o of the department of anesthesiology and intensive care

Ivanova A.A. – postgraduate student of the department of anesthesiology and intensive care

Full Text

9-6-2014.pdf

Received: 12/02/2015