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Case Reports
. 2020 Aug;50(2):292-297.
doi: 10.1007/s11239-020-02165-w.

Global haemostatic tests in rapid diagnosis and management of COVID-19 associated coagulopathy in acute limb ischaemia

Bingwen Eugene Fan  1   2   3   4 , Yew Woon Chia  5   6   7 , Christina Lai Lin Sum  8 , Ponnudurai Kuperan  9   10   6   7 , Stephrene Seok Wei Chan  9   10   6   7 , Li Min Ling  11   12   6   7 , Glenn Wei Leong Tan  13   6   7 , Serene Si Ning Goh  13 , Lai Har Wong  8 , Shu Ping Lim  8 , Kian Guan Eric Lim  8 , Hwee Tat Tan  8 , Mui Kia Ang  8 , Soon Lee Lau  8 , Kiat Hoe Ong  9   10   6   7 , Jensen Ng  14   6   7
Affiliations
Case Reports

Global haemostatic tests in rapid diagnosis and management of COVID-19 associated coagulopathy in acute limb ischaemia

Bingwen Eugene Fan et al. J Thromb Thrombolysis. 2020 Aug.
No abstract available

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
2 cm mobile thoracoabdominal aortic thrombus (blue arrow)
Fig. 2
Fig. 2
a Thromboelastography (TEG) performed at diagnosis of acute ischaemic limb. CK angle 78.6° (63°–78°) and CRT angle 80.3° (60°–78°) are increased, CK MA 69.2 mm (52–69 mm) and CRT MA 71.3 mm (52–70 mm) are also increased, CFF MA 43.8 mm (15–32 mm) is markedly increased secondary to hyperfibrinogenaemia, reflected by high functional fibrinogen (FLEV) 799.3 mg/dl. b Thromboelastography (TEG) on post-operative day 1 performed on citrated blood sample with IV heparin infusion. CK R is markedly prolonged 20.7 min (4.6–9.1 min) due to the heparin effect, while CKH R is borderline prolonged 10.5 min (4.3–8.3 min). CKH MA is still raised at 69.3 mm (52–69 mm), suggestive of a persistent hypercoagulable state in the absence of heparin, while CK MA is normal, suggestive that clot formation is normalised in presence of heparin. CFF MA 53.8 mm (15–32 mm) is further increased secondary to hyperfibrinogenaemia, reflected by higher functional fibrinogen (FLEV) 981.8 mg/dl which may be reflective of the postoperative infective systemic inflammatory milieu
Fig. 3
Fig. 3
aPTT clot waveform analysis showing markedly raised min1 of 9.715%/s, min2 of 1.566%/s, max2 of 1.311%/s and delta change of 0.9644, suggestive of a hypercoagulable state (patient’s clot waveform curve in black in comparison with 5 normal healthy individuals multicolour clot waveform curves). Reference ranges for min 1 (2.85–6.65%/s), min 2 (0.46–1.08%/s), max 2 (0.37–0.91%/s), delta change (0.10–0.41) were established at our centre based on 105 healthy individuals in accordance with the Clinical and Laboratory Standards Institute guidelines
See this image and copyright information in PMC

References

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