| Abstract | Uvođenje novog uređaja u laboratorij zahtijeva nužno verifikaciju postojećih analitičkih značajki i referentnih intervala koje je utvrdio proizvođač.
Referentni intervali zdravih ispitanika prsouv juetvrirtđi eten ir nefae vreenlitknoem in bterrovjua lzed ,rtea vsee poonpi uplraichivjea ćsarjeud najkeo E oudrsotpuep,a g dI 0je% m iis ppirtiapnaidkaam , oo.d Znao svneor infiek apcriijhuv jaeća djouv soel jnako on oad mstiunpima avlinšoe 2o0d uI 0 % ispitanika. Hemostaza kao pojam označava zaustavljanje krvarenja, a sustav hemostaze u ljudskom tijelu ima ulogu održati krv u tekućem stanju fiziološkim uvjetima, a kad nastupi ozljeda zaustaviti krvarenja. Takav sustav čine krvne žile, trom boci ti, faktori zgrušavanja, inhibitori zgrušavanja
i.O fsibnroivnnoeli tkičokaig suulasctaijvs.k eS vpir teit rčaigmeb keonjiec is eh ekmoroissttaez ze ai soptkitruijvua nsjee lapbooreramtoerćiajsjak izmgr tuešsatvoavnimjaa k ir vnia stua j: nparočtinro smeb ointksrkiov av rui jkemojee m(P jVe )d ,i jaekluti vsiursatnaov ap aprrcoijballenmo tTroom sub onpelzasatminjseknoj ivvrei pjermetrea (gAeP uT rVut)i,n tir o,amli bkinadsk joe vrirjiejčem o ek r(vTaVre)n ,j uk ogndcjeet rtraecbijaa hfiitbnroin iongteernvae, nkiorantci ettur anciisjua ktroormisbnoec. iMtaa in ais pimitijvea ndjueg aog trreagjaancjijee a tnroalmizbeo (coiktao.
4ov0i smnion )o. iZzbatoor us ete ust otivma . s2lu sčiatujeavciimjea p koovreizsatin Re Os vTiEsoMki mko rjii ziimkoam 4 kkravnaarlean jia u s uro okpue r2a0c imjei ni trdaoubmijue ssaem reez puolt saetib ai,n ialili zzbe okgo pjir oubklaezmujau z gnrau ušazvroankj ak rkvravrie. nOjad, kirurgija visoki rizik krvarenja je kod kardijalne ,vaskularne, transplatacije jetre , zamjene kuka i obstetričke intervencije. Pacijenti zbog krvarenja
nmeoproajtrue bnnae trtraannssfufuzzijiuje k. rVvai žin/iolis tp RonOoTvEnuM o-pa eurpacraijvuo ,j est ouga r ajez livkaožvnaonj puo zknirauvraštkio ugz rkorkv akrrevnajrae onjda pio lriejemčeitćia gjaa zngar uošdagvoavnajraa.j uIzć ik nriavčuilnje d tae mbio gser aimzb joesgimle zgrušavanja, vidljiva je i fibrinoliza, to su takozvane viskoelastične metode. Sonclot i TEG su prethodnici ROTEM-a ,ali zbog svojih izvedbenih mana
nkoisjue sper udžuag oi szkardarćžuajlei. bPorreadvnaoks tpi aRciOjeTnEtaM u- ba oslun jiecdi,n ao sstaamvinma itzimveed sbma asn ujpuujeta im trao nška oevker.a nTue si teolveik ktroojnei nčkuodmi s pu iEpeXtTomEM, b r(zvianna jiszkvi epdubte z,g droudšaavtnaen jian)f o,JrNmTaEciMje
(suu nnuatr atešmnjei lpjuu t)2, 2F IiBspTitEaMnik (afu pnoktcvirjđa efinbi rrineofegreennatn iin hinibteircvijaolmi d tirjoamgnboosctiičtak)i, kHoErPisTnEihM p a(hraempaertianraaz Fa)I Bi ATPETME, MJN (TapErMot iin iEnX inThEibMit otre fsitborvian o, liaz eH).E ZPaTkEljMuč nsoe
tumači u odnosu na JNTEM, a APTEM u odnosu na EXTEM. |
| Abstract (english) | The introduction of a new device into a laboratory requires verification of the existing analytical features and reference intervals established by the
manufacturer. The reference intervals are established on a large number of healthy population of Central Europe, where we belong. For verification,
it is necessary for at least 20 healthy respondents to check these reference intervals. They will be accepted if 10% or less of the respondents are out of
interval, or they will not be accepted if more than 10% of the respondents are out of it. Hemostasis as a term means stopping bleeding, and the
hemostasis system in the human body has the role of keeping blood in the fluid state under physiological conditions and when the injury occurs to
stop the bleeding. Such a system consists of blood vessels, platelets, coagulation factors, coagulation inhibitors and fibrinolytic system. Ali of these
hemostasis factors are tested by laboratory tests and thus reveal which pari of the system is a problem. The basic coagulation tests used to detect blood
clotting disorders are: prothrombin time (PV), activated partial thromboplastin time (APTV), thrombin time (TV), fibrinogen concentration, platelet
aggregation, and platelet aggregation assay. These are irreplaceable routine tests, but when it comes to bleeding, where they need to intervene urgently,
they are not useful. Their disandvantage is long duration of analysis (about 40 minutes) .Therefore, in these cases, ROTEM has 4 channels and within
20 min results of the analysis that indicate the cause of bleeding, depending on the choice of tests. 2 situations associated with high risk of bleeding
are the operation and trauma by itself, or because of the problem of blood clotting. Among the surgeries, high risk of bleeding is in cardiac, vascular,
liver transplants, hip replacement and obstetric intervention. Patients due to bleeding have to undergo blood transfusion and / or re-operation, so it is
important to know the cause of bleeding and treat it appropriately to avoid unnecessary transfusions. The importance of ROTEM is just to distinguish
surgical bleeding from clotting disorders. From the curve called temogram except coagulation, fibrinolysis is also apparent, so-called viscoelastic
methods. Sonclot and TEG are the predecessors of ROTEM, but due to their performance failures they did not last long. The benefits of ROTEM are
simple execution with on-screen instructions and electronic pipette, speed of performance, additional informations which provide and shorten the
patient's stay at the hospital, and thus reduces costs. Tests that are offered include EXTEM (extemal clotting pathway), INTEM (internal clotting
pathway), FIBTEM (fibrinogen function inhibiting platelet function), HEPTEM (heparinase) and APTEM (aprotinin fibrinolysis inhibitor). Based on
22 respondents, reference intervals for the diagnostically significant parameters of FIBTEM, lNTEM and EXTEM tests are confirmed, HEPTEM is
interpreted in relation to INTEM and APTEM compared to EXTEM. |
