Patient Blood Management: Clinical Hemotherapy and Hemostasis Management in Perioperative Settings

Görlinger, Klaus; Schlenke, Peter

doi:10.1159/000337794

Cited by 6 publications

(1 citation statement)

References 12 publications

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“…Therefore, the ability to predict intraoperative blood loss and transfusion requirements would be of great help to ensure adequate blood product supply and to enable appropriate therapy for patients at high bleeding risk [8,9,10,11]. This would also help anesthetists determining patients who are more likely to benefit from blood-salvaging techniques, prophylactic antifibrinolytic agents, and goal-directed therapy as an integral part of a patient blood management program [12,13,14,15,16]. Furthermore, it may help to reduce the quantity of blood prepared and reserved for patients at low risk of transfusion requirement with subsequent decrease in activity-based costs [17,18,19].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Fayed

Mourad

Yassen

et al. 2015

Transfus Med Hemother

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Background: The ability to predict transfusion requirements may improve perioperative bleeding management as an integral part of a patient blood management program. Therefore, the aim of our study was to evaluate preoperative thromboelastometry as a predictor of transfusion requirements for adult living donor liver transplant recipients. Methods: The correlation between preoperative thromboelastometry variables in 100 adult living donor liver transplant recipients and intraoperative blood transfusion requirements was examined by univariate and multivariate linear regression analysis. Thresholds of thromboelastometric parameters for prediction of packed red blood cells (PRBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate transfusion requirements were determined with receiver operating characteristics analysis. The attending anesthetists were blinded to the preoperative thromboelastometric analysis. However, a thromboelastometry-guided transfusion algorithm with predefined trigger values was used intraoperatively. The transfusion triggers in this algorithm did not change during the study period. Results: Univariate analysis confirmed significant correlations between PRBCs, FFP, platelets or cryoprecipitate transfusion requirements and most thromboelastometric variables. Backward stepwise logistic regression indicated that EXTEM coagulation time (CT), maximum clot firmness (MCF) and INTEM CT, clot formation time (CFT) and MCF are independent predictors for PRBC transfusion. EXTEM CT, CFT and FIBTEM MCF are independent predictors for FFP transfusion. Only EXTEM and INTEM MCF were independent predictors of platelet transfusion. EXTEM CFT and MCF, INTEM CT, CFT and MCF as well as FIBTEM MCF are independent predictors for cryoprecipitate transfusion. Thromboelastometry-based regression equation accounted for 63% of PRBC, 83% of FFP, 61% of cryoprecipitate, and 44% of platelet transfusion requirements. Conclusion: Preoperative thromboelastometric analysis is helpful to predict transfusion requirements in adult living donor liver transplant recipients. This may allow for better preparation and less cross-matching prior to surgery. The findings of our study need to be re-validated in a second prospective patient population.

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Section: Introductionmentioning

confidence: 99%

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Fayed

Mourad

Yassen

et al. 2015

Transfus Med Hemother

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Whole Blood Assay: Thromboelastometry – Bleeding Management Algorithms

Görlinger

Iqbal

Dirkmann

et al. 2021

Management of Bleeding Patients

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Management of Bleeding Patients

Teruya¹

2016

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Patient Blood Management: Clinical Hemotherapy and Hemostasis Management in Perioperative Settings

Cited by 6 publications

References 12 publications

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Whole Blood Assay: Thromboelastometry – Bleeding Management Algorithms

Management of Bleeding Patients

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