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Type: Journal article
Title: Thrombelastography in horses with acute gastrointestinal disease
Author: Epstein, K.
Brainard, B.
Gomez-Ibanez, S.
Lopes, M.
Barton, M.
Moore, J.
Citation: Journal of Veterinary Internal Medicine, 2011; 25(2):307-314
Publisher: Wiley
Issue Date: 2011
ISSN: 0891-6640
Statement of
K.L. Epstein, B.M. Brainard, S.E. Gomez-Ibanez, M.A.F. Lopes, M.H. Barton, and J.N. Moore
Abstract: Background: Coagulopathies in horses with gastrointestinal disease are frequently identified and associated with morbidity and fatality. Objective: Determine if thrombelastography (TEG) identifies abnormalities associated with lesion type, presence of systemic inflammatory response syndrome (SIRS), morbidity, and fatality more consistently than traditional coagulation testing. Animals: One-hundred and one horses examined for gastrointestinal disease and 20 healthy horses. Methods: TEG, tissue factor (TF)-TEG, and traditional coagulation panels parameters and percentages of horses with coagulopathies were compared for lesion type, presence of SIRS, complications, and survival. Results: Changes in individual parameters and increased incidence of coagulopathies were associated with fatality (R, P= .007; k-value [K], P= .004; clot lysis [CL]30, P= .037; CL60, P= .050; angle [Ang], P= .0003; maximum amplitude [MA], P= .006; lysis [Ly]30, P= .042; Ly60, P= .027; CI, P= .0004; ≥ 2 TEG coagulopathies, P= .013; ≥ 3 TEG coagulopathies, P= .038; TF-R, P= .037; TF-K, P= .004; TF-CL30, P < .0001; TF-CL60, P < .0001; TF-Ang, P= .005; TF-Ly30, P= .0002; TF-Ly60, P < .0001; TF-CI, P= .043; ≥ 1 TF-TEG coagulopathies, P= .003; ≥ 2 TF-TEG coagulopathies, P= .0004; prothrombin tme [PT], P < .0001; activated partial throboplastin time [aPTT], P= .021), inflammatory lesions (MA, P= .013; TF-CL30, P= .033; TF-CL60, P= .010; TF-Ly60, P= .011; ≥ 1 TF-TEG coagulopathy, P= .036; ≥ 2 TF-TEG coagulopathy, P= .0007; PT, P= .0005; fibrinogen, P= .019), SIRS (MA, P= .004; TF-CL30, P= .019; TF-CL60, P= .013; TF-Ly30, P= .020; TF-Ly60, P= .010; PT, P < .0001; aPTT, P= .032; disseminated intravascular coagulation, P= .005), and complications (ileus: aPTT, P= .020; diarrhea: TF-CL30, P= .040; TF-Ly30, P= .041; thrombophlebitis: ≥ 1 TF-TEG coagulopathy, P= .018; laminitis: MA, P= .004; CL60, P= .045; CI, P= .036; TF-MA, P= .019; TF-TEG CI, P= .019). Abnormalities in TEG and TF-TEG parameters were indicative of hypocoagulation and hypofibrinolysis. Conclusions and Clinical Importance: TEG identifies changes in coagulation and fibrinolysis associated with lesion type, SIRS, morbidity, and fatality in horses with gastrointestinal disease.
Keywords: Coagulopathy; point-of-care coagulation testing; viscoelastic coagulation testing
Rights: Copyright © 2011 by the American College of Veterinary Internal Medicine. Journal of Veterinary Internal Medicine articles are published under the terms of the Creative Commons Attribution Non-Commercial License (CC BY NC), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
DOI: 10.1111/j.1939-1676.2010.0673.x
Appears in Collections:Animal and Veterinary Sciences publications
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