Thrombelastography (TEG) decreases blood products requirement before invasive procedures in cirrhotic patients with coagulation tests derangement. A randomized controlled trial

Pietri, Lesley De; Bianchini, Maria Anastasia; Montalti, Roberto; Maria, Nicola De; Maira, Tommaso Di; Begliomini, B.; Gerunda, G.E.; Villa, Erica

doi:10.1016/j.dld.2014.01.017

Cited by 7 publications

(2 citation statements)

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“…De Pietri et al 17 reported that even with factoring in additional costs with performing a TEG test on every patient with liver disease, overall transfusion costs were lower in the patient population that received a TEG test compared with those with conventional coagulation testing only.…”

Section: Discussionmentioning

confidence: 99%

Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)

Peterson¹,

Webb

Vipler

2016

BMJ Case Reports

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In the presented case, the authors describe an obese middle-aged man that presented to the emergency department for persistent oedema, scleral icterus and fatigue. He was admitted to the hospital and diagnosed with liver cirrhosis via transjugular liver biopsy. He continued to bleed from the biopsy site for 5 days from accelerated intravascular coagulation and fibrinolysis (AICF) requiring multiple transfusions of packed red blood cells, fresh-frozen plasma and cryoprecipitate. The authors then used thromboelastography (TEG) to further characterise the patient's coagulopathy, which revealed platelet inhibition. The results of the TEG significantly changed future transfusion management. Finally, the authors conducted a literature review to summarise the current literature available for the use of TEG in the management of liver cirrhosis with AICF.

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Section: Discussionmentioning

confidence: 99%

Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)

Peterson¹,

Webb

Vipler

2016

BMJ Case Reports

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“…At present, ROTEM™ or TEG™ may be useful in guiding direct therapeutic interventions in the actual case of bleeding [111••]; TEG is in fact used to guide therapy during liver transplantation in many centers [112][113][114] and is gaining importance in the assessment of liver-disease associated hemostasis alterations [115,116], with a possible role in predicting variceal rebleeding [32] and guiding preprocedural transfusions [117]. However, although most studies suggest that TEG provides a better assessment of bleeding risk than standard tests of hemostasis in patients with liver disease, it should be emphasized that no studies have directly tested this possibility.…”

Section: Laboratory Methods For the Assessment Of Hemostatic Status Amentioning

confidence: 99%

Assessment of Bleeding Risk in Patients with Cirrhosis

Zanetto

Senzolo

Ferrarese

et al. 2015

Curr Hepatology Rep

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Cirrhosis is characterized by varying degrees of alterations of the different components of hemostasis, including thrombocytopenia, reduction of procoagulant factors, overactivation of the fibrinolytic system, and a precarious hemostatic equilibrium that can easily tilt towards bleeding. Predicting the risk of spontaneous bleeding from nonvariceal sites, variceal bleeding, and hemorrhagic complications associated with surgery or invasive procedures is a formidable challenge faced by clinicians caring for cirrhosis patients, and standard assays have demonstrated a poor correlation with episodes of bleeding. While new tests evaluating different components of coagulation as well as global assays are increasingly available and used to guide therapeutic approaches, there is still no optimal method to assess bleeding risk, and a combination between severity of liver disease, the presence of ongoing infection or renal insufficiency, as well as the type of bleeding itself seems to still be very important in evaluating the individual patient's risk.

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Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding

Wikkelsø

Wetterslev

Møller

et al. 2016

Cochrane Database of Systematic Reviews

310

304

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Thrombelastography (TEG) decreases blood products requirement before invasive procedures in cirrhotic patients with coagulation tests derangement. A randomized controlled trial

Cited by 7 publications

References 0 publications

Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)

Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF)

Assessment of Bleeding Risk in Patients with Cirrhosis

Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding

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