Application value of thromboelastography in perioperative clinical blood transfusion and its effect on the outcome of patient

Abstract

Application value of thromboelastography (TEG) in perioperative clinical blood transfusion and its effect on the outcome of patient were investigated. Seventy-four patients, admitted to The Surgical Department of the First Hospital of Zibo from March 2015 to March 2018, were selected for this study. Among them, 34 patients took only the traditional coagulation function testing method as the blood transfusion guide during the perioperative period and they were regarded as the control group. The other 40 patients used TEG as the blood transfusion guide during the perioperative period, and they were regarded as the TEG group. The coagulation function indicators in 2 h before the operation and in 24 h after the operation, the transfusion amount and blood loss during the operation, the condition of the blood transfusion during the perioperative period, the occurrence rate of the postoperative rebleeding, the length of hospital stay and mortality of the patients in the two groups were compared. The coagulation function indicators of the patients in the two groups in 2 h before the operation and in 24 h after the operation showed that there was no significant difference between the two groups (P>0.050). However, APTT and Pt of the patients in the two groups both increased when compared with those before the treatment (P<0.050) and Hb, Hct, Plt and Fib all decreased (P<0.050). The suspended erythrocytes, Plt, fibrinogen and plasma in the TEG group were both significantly lower than those in the control group (P<0.001). Compared with the traditional coagulation function test, TEG was more accurate for estimating the coagulation function of patient and was more suitable for estimating the condition of blood transfusion of patient in the perioperative period; also, it could shorten the recovery period of patient and it is worthwhile to promote it in the clinic.

Thromboelastography in the Perioperative Period: A Literature Review

“…Using TEG-PM in monitoring platelet inhibition in patients on clopidogrel was useful in decreasing unneeded treatment cancellations besides the patient risk [192]. However, comparing the conventional transfusion protocol to TEG-guided transfusion revealed no significant difference in detecting bleeding [193]. The conventional TEG parameters with the celite-activated ones were predictive or associated with hypercoagulability or thrombotic events [194][195][196].…”

“…The conventional TEG parameters with the celite-activated ones were predictive or associated with hypercoagulability or thrombotic events [ 194 - 196 ]. Coagulopathy prediction was achieved also by TEG-guided transfusion compared to the use of conventional methods [ 193 ]. Also, they showed better prediction values of survival rates compared to other conventional methods [ 197 ].…”

“…Also, they showed better prediction values of survival rates compared to other conventional methods [ 197 ]. On the other hand, TEG-guided transfusion was not different to the conventional protocol in the prediction of mortality [ 193 ]. They could predict the blood products use [ 191 ] and using TEG-guided transfusion was effective in reducing the need for blood products [ 193 ].…”

“…On the other hand, TEG-guided transfusion was not different to the conventional protocol in the prediction of mortality [ 193 ]. They could predict the blood products use [ 191 ] and using TEG-guided transfusion was effective in reducing the need for blood products [ 193 ]. Moreover, they resembled a good option to guide the optimal treatment, especially in patients comorbid with Gaucher disease who undergoing general surgeries [ 198 ].…”