ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2025
Rotational thromboelastometry helped reduce prophylactic blood product use for port insertion in patients with liver failure undergoing plasma exchange.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivePlasma exchange (PLEX) is used to treat liver failure patients who have coagulopathy. There is no consensus regarding pre-procedural blood product transfusion prior to PLEX port placement among patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). The primary objective was to study the difference in prophylactic blood product use in patients with ALF and ACLF who had rotational thromboelastometry (ROTEM) done prior to PLEX port insertion (ROTEM group -RG) compared with those patients in whom ROTEM was not done (conventional coagulation group-CG). Secondary objectives were to study local port site-related bleeding events between these groups and the correlation between ROTEM parameters and conventional coagulation tests (CCT), in patients with ALF and ACLF.
methodsWe retrospectively analyzed consecutive patients who underwent PLEX for ALF and ACLF using central venous access (11.5 F and 10 F catheter for adult and pediatric patients, respectively) between October 2016 and February 2022. The prophylactic transfusion strategy in CG was based on CCT and RG was based on CCT and ROTEM parameters. Propensity score matching (PSM) was done separately for ALF and ACLF between RG and CG.
resultsTotal 88/113 patients with ALF/ACLF underwent PLEX. In PSM matched 77 ALF/108 ACLF patients, prophylactic blood products use was significantly less in RG (18/50 [36%]/12/85 [14%]) compared CG (21/27 [78%]/18/23 [78%]; p < 0.001). Local port site bleeding events were noted in two ACLF patients (one in RG and one in CG) and none in ALF. In ALF/ACLF patients, the correlation between clotting time (CT, ROTEM) and prothrombin time international normalized ratio (PT-INR, CCT) was 0.29/0.35 (weak), respectively, between maximum clot firmness (MCF, ROTEM) and fibrinogen was 0.68/0.76 (strong), respectively, and between maximum clot firmness (MCF, ROTEM) and platelet was 0.56/0.71 (moderate/strong), respectively.
conclusionThe use of a ROTEM-based transfusion strategy prior to PLEX port insertion helped reduce prophylactic blood product transfusion among patients with ALF and ACLF.
Indexed as
Identifiers
41107621What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.