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- Title
TEG GUIDED PRE-PROCEDURE COAGULOPATHY SCREEN IN CIRRHOTICS.
- Authors
Padhi, Shivadatta; Tyagi, Vandana; Maharshi, Sudhir; Gupta, Gaurav; Nijhawan, Sandeep
- Abstract
Background and Aims Hemostasis in cirrhotics exist in rebalance, defects in prohemostatic drivers are compensated by commensurate changes in antihemostatic drivers. Conventional coagulation tests (CCTs) in cirrhotics assess only procoagulant factors therefore poor predictors of bleeding risk. CCTs are routinely used before invasive procedures and attempts are made to correct these abnormalities before invasive procedures such practices are not evidence-based, and may even be harmful. Thromboelastography (TEG) hence is promising in evaluating the coagulation status of cirrhotics prior to procedures. TEG-guided transfusion can avoid unnecessary blood product transfusions. Methods The prospective study included 133 cirrhotic patients undergoing central line placement, Conventional coagulation tests (CCTs), and Thromboelastography (TEG) were done in all patients and they were observed for postprocedural bleeding. Results 133 cirrhotic patients (mean age of 46 yrs, 90.9% males) with 90.9% and 9.1% patients in child t pugh (CTP) class B, C. All underwent central line placement. Bleeding time, clotting time were normal in all. PT/INR was prolonged in all. Comparison of TEG parameters (Rtime and MA) with INR and platelet counts showed a lower percentage of abnormal values of R time and MA value compared to INR and platelet count, with no post-procedural bleed. No correlation between CCTs and TEG variables and CTP score. None received blood transfusion preprocedure. Conclusion Abnormal CCTS do not predict bleeding risk, TEG guided coagulopathy assessment is an important pre-invasive procedure evaluation for individuals with cirrhosis.
- Subjects
PLATELET count; BLOOD transfusion; BLOOD coagulation disorders; BLOOD products; THROMBELASTOGRAPHY; HEMOSTASIS
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2024, Vol 15, Issue 1, p1439
- ISSN
0975-3583
- Publication type
Article