%0 Journal Article
%T Tromboelastograf赤a: nuevos conceptos en la fisiolog赤a de la hemostasia y su correlaci車n con la coagulopat赤a asociada al trauma Thromboelastography: New concepts in haemostasis physiology and correlation with trauma associated coagulopathy
%A Kenny Galvez
%A Claudia Cortes
%J Revista Colombiana de Anestesiolog赤a
%D 2012
%I Sociedad Colombiana de Anestesiolog赤a
%X La interpretaci車n inicial del proceso de coagulaci車n mencionaba la presencia de 2 v赤as: la extr赤nseca, formada por el factor tisular (FT) y el factor VII, y la intr赤nseca, en la que participan los factores XII, XI, IX, VIII y V. Hoy en d赤a este concepto ha cambiado y se acepta de forma categ車rica que el evento iniciador principal de la coagulaci車n sangu赤nea es la exposici車n del FT. En este art赤culo revisamos los nuevos conceptos de la cascada de coagulaci車n con los hallazgos de la tromboelastograf赤a y los diferentes mecanismos que precipitan la coagulopat赤a asociada al trauma. Para tal fin se realiz車 una b迆squeda sistem芍tica en las principales bases de datos, como Medline, Embase y Lilacs, en el periodo comprendido entre 2000 y 2011. Se encontraron 114 art赤culos, de los cuales se tomaron 50 para realizar la revisi車n. Como hallazgo relevante se encontr車 que la tromboelastograf赤a permite detectar con precisi車n el defecto subyacente en la cascada de coagulaci車n, y de esta manera se ha convertido en una herramienta 迆til e indispensable para guiar el manejo de la coagulopat赤a asociada al trauma. Initial interpretation of the process of coagulation refers to two pathways: (1) the extrinsic pathway, consisting of tissue factor (TF) and factor VII, and (2) the intrinsic pathway, in which factors XII, XI, IX, VIII and V are involved. Currently, this concept has changed and it is accepted that the main initiating event in blood coagulation is TF exposure. In this article, we review the new concepts of the coagulation cascade based on thromboelastography findings and the different mechanisms involved in trauma-associated coagulopathy. For this purpose, a systematic research was carried out using the main databases, including Medline, Embase and Lilacs between 2000 and 2011. One hundred and fourteen articles were found, and 50 were selected for the review. A relevant finding was that thromboelastography allows a precise detection of the underlying flaw in the coagulation cascade. Therefore, this procedure has become an essential tool and a guide for the management of trauma-associated coagulopathy.
%K Hemostasis
%K Tromboelastograf赤a
%K Heridas y traumatismos
%K Coagulaci車n sangu赤nea
%K Hemostasis
%K Thromboelastography
%K Wounds and injuries
%K Blood coagulation
%U http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-33472012000300011