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​TEG and TXA: Lifesaving or Time- and Money-Wasting? 


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ErroTEG and TXA: Lifesaving or Time- and Money-Wasting? 
AAST Webinar, February 3, 2016

Presented by:
Matthew Martin, Madigan Army Medical Center, Tacoma, Washington
Dr. Bryan Cotton, University of Texas Health Science Center, Houston, Texas

Moderated by:
Dr. Peter Rhee, University of Arizona, Tucson, Arizona

Referenced in presentation:

Overwhelming tPA release, not PAI-1 degradation, is responsible for hyperfibrinolysis in severely injured trauma patients.
Chapman MP, Moore EE, Moore HB, Gonzalez E, Gamboni F, Chandler JG, Mitra S, Ghasabyan A, Chin TL, Sauaia A, Banerjee A, Silliman CC.
J Trauma Acute Care Surg. 2016 Jan;80(1):16-23; discussion 23-5.

The impact of tranexamic acid on mortality in injured patients with hyperfibrinolysis.
Harvin JA, Peirce CA, Mims MM, Hudson JA, Podbielski JM, Wade CE, Holcomb JB, Cotton BA.
J Trauma Acute Care Surg. 2015 May;78(5):905-9; discussion 909-11.

Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX).
Eckert MJ, Wertin TM, Tyner SD, Nelson DW, Izenberg S, Martin MJ.
J Trauma Acute Care Surg. 2014 Dec;77(6):852-8; discussion 858.

Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: the spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy.
Moore HB, Moore EE, Gonzalez E, Chapman MP, Chin TL, Silliman CC, Banerjee A, Sauaia A.
J Trauma Acute Care Surg. 2014 Dec;77(6):811-7; discussion 817.

Do all trauma patients benefit from tranexamic acid?
Valle EJ, Allen CJ, Van Haren RM, Jouria JM, Li H, Livingstone AS, Namias N, Schulman CI, Proctor KG.
J Trauma Acute Care Surg. 2014 Jun;76(6):1373-8.

Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury.
Meyer AS, Meyer MA, Sørensen AM, Rasmussen LS, Hansen MB, Holcomb JB, Cotton BA, Wade CE, Ostrowski SR, Johansson PI.
J Trauma Acute Care Surg. 2014 Mar;76(3):682-90.

Tranexamic acid corrects fibrinolysis in the presence of acidemia in a swine model of severe ischemic reperfusion.
DeBarros M, Hatch Q, Porta CR, Salgar S, Izenberg S, DuBose J, Eckert M, Martin M.
J Trauma Acute Care Surg. 2014 Mar;76(3):625-32; discussion 632-3.

Fibrinolysis greater than 3% is the critical value for initiation of antifibrinolytic therapy.
Chapman MP, Moore EE, Ramos CR, Ghasabyan A, Harr JN, Chin TL, Stringham JR, Sauaia A, Silliman CC, Banerjee A.
J Trauma Acute Care Surg. 2013 Dec;75(6):961-7; discussion 967.

The International Normalized Ratio overestimates coagulopathy in stable trauma and surgical patients.
McCully SP, Fabricant LJ, Kunio NR, Groat TL, Watson KM, Differding JA, Deloughery TG, Schreiber MA.
J Trauma Acute Care Surg. 2013 Dec;75(6):947-53.

Tranexamic acid in trauma: how should we use it?
Napolitano LM, Cohen MJ, Cotton BA, Schreiber MA, Moore EE.
J Trauma Acute Care Surg. 2013 Jun;74(6):1575-86.

Defining when to initiate massive transfusion: a validation study of individual massive transfusion triggers in PROMMTT patients.
Callcut RA, Cotton BA, Muskat P, Fox EE, Wade CE, Holcomb JB, Schreiber MA, Rahbar MH, Cohen MJ, Knudson MM, Brasel KJ, Bulger EM, Del Junco DJ, Myers JG, Alarcon LH, Robinson BR; PROMMTT Study Group.
J Trauma Acute Care Surg. 2013 Jan;74(1):59-65, 67-8; discussion 66-7.

Hyperfibrinolysis at admission is an uncommon but highly lethal event associated with shock and prehospital fluid administration.
Cotton BA, Harvin JA, Kostousouv V, Minei KM, Radwan ZA, Schöchl H, Wade CE, Holcomb JB, Matijevic N.
J Trauma Acute Care Surg. 2012 Aug;73(2):365-70; discussion 370.

Admission rapid thrombelastography predicts development of pulmonary embolism in trauma patients.
Cotton BA, Minei KM, Radwan ZA, Matijevic N, Pivalizza E, Podbielski J, Wade CE, Kozar RA, Holcomb JB.
J Trauma Acute Care Surg. 2012 Jun;72(6):1470-5; discussion 1475-7.

Rapid thrombelastography delivers real-time results that predict transfusion within 1 hour of admission.
Cotton BA, Faz G, Hatch QM, Radwan ZA, Podbielski J, Wade C, Kozar RA, Holcomb JB.
J Trauma. 2011 Aug;71(2):407-14; discussion 414-7.

Can RapidTEG accelerate the search for coagulopathies in the patient with multiple injuries?
Jeger V, Zimmermann H, Exadaktylos AK.
J Trauma. 2009 Apr;66(4):1253-7.​