Evidence map›Paper›PMID 39036674›Full record

ArticleAsian journal of transfusion science

Tailoring transfusion strategy using thromboelastogram in goal-directed massive transfusion: Impact on transfusion requirements and clinical outcomes.

P A Prethika, Ganesh Mohan, Shamee Shastry, Jayaraj Mymbilly Balakrishnan

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Article in Asian journal of transfusion science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

P A PrethikaDepartment of Immunohematology and Blood Transfusion, Apollo Hospitals, Chennai, Tamil Nadu, India.
Ganesh MohanDepartment of Immunohaematology and Blood Transfusion, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Udupi, Karnataka, India.
Shamee ShastryDepartment of Immunohaematology and Blood Transfusion, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Udupi, Karnataka, India.
Jayaraj Mymbilly BalakrishnanDepartment of Emergency Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Udupi, Karnataka, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveWe compared the overall clinical outcome in formula-based protocol (1:1:1) and thromboelastogram (TEG)-guided goal-based massive transfusion (MT) in the resuscitation of patients with hemorrhagic shock. MATERIALS AND

methodsThis was a retro-prospective case-control study conducted over a period of 2 years among the patients who received MT using a 1:1:1 fixed ratio protocol (controls, Group A) and goal-based protocol (cases, Group B) guided through TEG. Patients were matched for the type and severity of the clinical conditions. Utilization of blood components, clinical outcomes, transfusion-related complications, and total mortality rates were compared between the groups.

resultsThere were 113 patients in the formula-based group and 109 patients in the goal-based transfusion group who were matched for injury severity scores. The total blood components utilized were 1867 and 1560, respectively, with a 17.7% reduction associated with the use of TEG. Patients were divided into normal, hypo, and hypercoagulable based on TEG, and a higher transfusion rate was associated with hypocoagulable TEG (942 vs. 610). The prothrombin time, activated partial thromboplastin time, R time, and K time had a significant positive correlation with the need to transfuse more than 20 blood components, whereas platelet count, base excess, alpha angle, MA, and CI had a negative correlation (

conclusionTEG-guided goal-based approach helped to reduce blood component utilization with a reduced incidence of coagulopathy at the end of the MT while improving patient survival.

Indexed as

Blood utilizationgoal-directed massive transfusionhemorrhagic shockmassive transfusionthromboelastogram

Identifiers

PMID39036674
PMCPMC11259345

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