Objective: This study analysed the relationships between the main thromboelastography (TEG) parameters, the platelet (PLT) count and clinical bleeding in patients with blood diseases. We explored the threshold of the relevant parameters in the pathological condition of bleeding, aiming to scientifically guide clinical prophylactic PLT transfusion.Methods: In total, 268 patients with clear diagnoses of blood diseases and thrombocytopenia were enrolled and divided into five groups, A, B, C, D and E, corresponding to PLT counts of 0-10 Â 10 9 /L, 11-20 Â 10 9 /L, 21-30 Â 10 9 /L, 31-50 Â 10 9 /L and 51-100 Â 10 9 /L, respectively. TEG and routine blood testing were performed simultaneously, the main TEG parameters and the PLT count were analysed, and the thresholds of the main TEG parameters in each group when the patient had bleeding were obtained.
Results:The maximum amplitude (MA) in groups A, B and C increased gradually, with a significant difference between each pair of these groups (P < 0.05). In groups A, B, C, D and E, the corresponding MA at the time of bleeding was 43.5 mm, 39.6 mm, 38.0 mm, 35.2 mm and 50.5 mm, respectively, with statistically significant differences (P < 0.05).
Conclusions:The MA can be used as a reference indicator for preventive PLT transfusion to a certain extent. When the PLT count is within different ranges, the MA threshold for preventive PLT transfusion also differs. It is recommended that different PLT counts be correlated with different MA thresholds to guide clinical prophylactic PLT transfusion.bleeding risk, blood transfusion, platelet count, thrombocytopenia, Thromboelastography 1 | BACKGROUND Thrombocytopenia and bleeding are common clinical manifestations of blood system diseases, and platelet (PLT) transfusion is often used for clinical treatment. However, as a rare resource, blood is in short supply in China and worldwide, but the demand is increasing yearly.According to statistics, approximately 1.25 and 2.2 million units of PLTs were used in clinical applications in China and the United States, respectively, in 2014; however, these numbers are currently on the rise. 1 In current clinical practice, the preventive infusion is generally given when the PLT count is 10 Â 10 9 /L or lower 2-5 ; however, in clinical practice, the setting of this index cannot fully reflect the real haemostatic state of the body, and there are some disadvantages. Therefore, it is very important to explore comprehensive and effective haemostatic detection indexes to guide PLT transfusion. As a new technology, thromboelastography (TEG) can not only be used to