期刊
AMERICAN JOURNAL OF SURGERY
卷 220, 期 6, 页码 1379-1386出版社
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2020.07.034
关键词
Liver transplantation; Hemostatic resuscitation; Thrombelastography; Clinical coagulopathy; Coagulopathy score
类别
资金
- National Heart Lung and Blood Institute [K99HL151887]
- American Society of Transplant Surgeons Veloxis Fellowship Award
- University of Colorado Academic Enrichment Fund
Background: An NIH clinical coagulopathy score has been devised for trauma patients, but no such clinical score exists in transplantation surgery. We hypothesize that that this coagulopathy score can effectively identify laboratory defined coagulopathy during liver transplantation and correlates to blood product utilization. Methods: TEGs were performed and coagulopathy scores (1, normal bleeding 5, diffuse coagulopathic bleeding) were assigned by the surgeons at 5 intra-operative time points. Blood products used during the case were recorded between time points. Statistical analyses were performed to identify correlations between coagulopathy scores, TEG-detected abnormalities, and blood product utilization. Result: Transfusions rarely correlated with the appropriate TEG measurements of coagulation dysfunction. Coagulopathy score had significant correlation to various transfusions and TEG-detected coagulopathies at multiple points during the case. High aggregate coagulopathy scores identified patients receiving more transfusions, re-operations, and longer hospital stays Conclusion: The combination of viscoelastic testing and a standardized clinical coagulopathy score has the potential to optimize transfusions if used in tandem as well as standardize communication between surgery and anesthesia teams about clinically evident coagulopathy. (c) 2020 Published by Elsevier Inc.
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