Transfusional optimization in liver transplant using viscoelastic test guided therapy

Autor: A. Valdivieso Lopez, R.M. Gutierrez Rico, N. Lekerika Royo, A. Martínez Ruiz, J. Arco Vázquez, E. Arana Arri, L. Prieto Molano
Rok vydání: 2020
Předmět:
Zdroj: Revista Española de Anestesiología y Reanimación (English Edition). 67:292-300
ISSN: 2341-1929
DOI: 10.1016/j.redare.2020.01.011
Popis: Background Assess the reduction of packed red blood cells (PRBCs) transfusion in liver transplantation (LT) after the introduction of the thromboelastometry as intraoperative coagulation monitor. Methods We conducted a retrospective cohort study (n = 92), randomized into two groups: group A (control), in whom transfusion therapy was based on conventional laboratory tests (CLT), and group B (ROTEM), whose blood transfusion was performed as protocolized algorithms, guided by thromboelastometry (ROTEM). We analyzed packed red blood cells (PRBCs) units, transfused units of fresh frozen plasma (FFP), platelets units, fibrinogen and tranexamic acid. We used the Chi square test for the comparison of proportions and Student's t test to compare means when the distribution was normal. Otherwise, Mann–Whitney U test was performed. Results In group A 84.8% of patients required transfusion of PRBCs, with a median (IQR) of 4 (1.5–6), compared with 67.4% in group B with a median (IQR) of 2 (0–4) (p Conclusions The introduction of thromboelastometry (ROTEM) measurements in hemostatic therapy algorithms reduces the transfusion rate of FFP and PRBCs during liver transplantation. The using of ROTEM derived thresholds leads to detecting higher requirements of fibrinogen compared to conventional laboratory tests.
Databáze: OpenAIRE
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