You must keep in mind that laboratory tests on their own are not definitive for the clinical management of patients, but are rather complementary to the data collected during the anamnesis and the physical work-up; they are no substitute to the physician's criterion but may guide the diagnosis and the therapeutic approach adopted. 1. Di Benedetto P, Baciarello M, Cabetti L, et al. Thrombelastography. Present and future perspectives in clinical practice. Minerva Anestesiol. 2003;69:501- 9,509-15. 3. Ak K, Isbir CS, Tetik S, et al. Thromboelastographybased transfusion algorithm reduces blood product use after elective CABG: a prospective randomized study. J Card Surg. 2009;24:404-10. 4. Wasowicz M, McCluskey SA, Wijeysundera DN, et al. The incremental value of thrombelastography for prediction of excessive blood loss after cardiac surgery: an observational study. Anesth Analg. 2010;111: 331-8. 5. American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Anesthesiology. 2006;105:198-208. 7. Dai Y, Lee A, Critchley LA, et al. Does thromboelastography predict postoperative thromboembolic events? A systematic review of the literature. Anesth Analg. 2009;108:734-42. 8. Park MS, Martini WZ, Dubick MA, et al. Thromboelastography as a better indicator of hypercoagulable state after injury than prothrombin time or activated partial thromboplastin time. J Trauma. 2009;67:266,75; discussion 275-6. 9. Chen A, Teruya J. Global hemostasis testing thromboelastography: old technology, new applications. Clin Lab Med. 2009;29:391-407. 10. Schreiber MA, Differding J, Thorborg P, et al. Hypercoagulability is most prevalent early after injury and in female patients. J Trauma. 2005;58:475,80; discussion 480-1. 11. Sharma P, Saxena R. A novel thromboelastographic score to identify overt disseminated intravascular coagulation resulting in a hypocoagulable state. Am J Clin Pathol. 2010;134:97-102. 12. Wilson D, Cooke DA, McNally MA, et al. Changes in coagulability as measured by thrombelastography following surgery for proximal femoral fracture. Injury. 2001;32:765-70. 13. McCrath DJ, Cerboni E, Frumento RJ, et al. Thromboelastography maximum amplitude predicts postoperative thrombotic complications including myocardial infarction. Anesth Analg. 2005;100:1576-83. 14. Zufferey P, Merquiol F, Laporte S, et al. Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology. 2006;105:1034-46. 15. Benoni G, Fredin H, Knebel R, et al. Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations. Acta Orthop Scand. 2001;72:442-8. 16. Ickx BE, van der Linden PJ, Melot C, et al. Comparison of the effects of aprotinin and tranexamic acid on blood loss and red blood cell transfusion requirements during the late stages of liver transplantation. Transfusion. 2006;46:595-605. 17. Gallimore MJ, Harris SL, Tappenden KA, et al. Urokinase induced fibrinolysis in thromboelastography: a model for studying fibrinolysis and coagulation in whole blood. J Thromb Haemost. 2005;3:2506-13. 18. Zmuda K, Neofotistos D, Ts'ao CH. Effects of unfractionated heparin, low-molecular-weight heparin, and heparinoid on thromboelastographic assay of blood coagulation. Am J Clin Pathol. 2000;113:725-31. 19. Coppell JA, Thalheimer U, Zambruni A, et al. The effects of unfractionated heparin, low molecular weight heparin and danaparoid on the thromboelastogram TEG: an in-vitro comparison of standard and heparinase-modified TEGs with conventional coagulation assays. Blood Coagul Fibrinolysis. 2006;17:97-104. 20. Simons R, Mallett SV. Use of thromboelastography to demonstrate persistent anticoagulation after stopping enoxaparin. Anaesthesia. 2007;62:1175-8. 21. Van PY, Cho SD, Underwood SJ, et al. Thrombelastography versus AntiFactor Xa levels in the assessment of prophylactic-dose enoxaparin in critically ill patients. J Trauma. 2009;66:1509,15; discussion 1515-7. 22. Klein SM, Slaughter TF, Vail PT, et al. Thromboelastography as a perioperative measure of anticoagulation resulting from low molecular weight heparin: a comparison with anti-Xa concentrations. Anesth Analg. 2000;91:1091-5. 23. Modi HN, Suh SW, Hong JY, et al. Intraoperative blood loss during different stages of scoliosis surgery: A prospective study. Scoliosis. 2010;5:16. 24. Coppola A, Di Minno G. Desmopressin in inherited disorders of platelet function. Haemophilia. 2008;14 Suppl 1:31-9. 25. Theroux MC, Corddry DH, Tietz AE, et al. A study of desmopressin and blood loss during spinal fusion for neuromuscular scoliosis: a randomized, controlled, double-blinded study. Anesthesiology. 1997;87: 260-7. 26. Stevens W, Koene H, Zwaginga JJ, et al. Chronic idiopathic thrombocytopenic purpura: present strategy, guidelines and new insights. Neth J Med. 2006;64:356-63. 27. Webert KE, Mittal R, Sigouin C, et al. A retrospective 11-year analysis of obstetric patients with idiopathic thrombocytopenic purpura. Blood. 2003;102: 4306-11.
Cabe recordar que las pruebas de laboratorio por sí solas no son determinantes en el manejo clínico de los pacientes, sino que son un complemento a los datos recolectados durante la anamnesis y el examen físico, y que, como tales, no reemplazan el criterio médico, pero sí pueden guiar el diagnóstico y la terapéutica por seguir.