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Association between viscoelastic tests-guided therapy with synthetic factor concentrates and allogenic blood transfusion in liver transplantation: a before-after study

التفاصيل البيبلوغرافية
العنوان: Association between viscoelastic tests-guided therapy with synthetic factor concentrates and allogenic blood transfusion in liver transplantation: a before-after study
المؤلفون: Flavio Takaoka, Nicole P. Juffermans, Ary Serpa Neto, Thiago Chaves Amorim, Veronica Neves Fialho Queiroz, Jordana D. O. Lira, Luiz Guilherme Villares da Costa, Raffael P. C. Zamper
المساهمون: Intensive Care Medicine, AII - Inflammatory diseases, Graduate School
المصدر: BMC Anesthesiology
BMC anesthesiology, 18(1):198. BioMed Central
BMC Anesthesiology, Vol 18, Iss 1, Pp 1-12 (2018)
بيانات النشر: BioMed Central, 2018.
سنة النشر: 2018
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Blood Loss, Surgical, Hemorrhage, Platelet Transfusion, 030204 cardiovascular system & hematology, Liver transplantation, lcsh:RD78.3-87.3, 03 medical and health sciences, Plasma, 0302 clinical medicine, 030202 anesthesiology, medicine, Humans, Blood Transfusion, Hospital Mortality, Prospective Studies, Retrospective Studies, Hemostasis, business.industry, Prothrombin complex concentrate, Fibrinogen, Perioperative, Length of Stay, Middle Aged, Blood Coagulation Factors, Surgery, Thrombelastography, Thromboelastometry, Anesthesiology and Pain Medicine, Technical Advance, lcsh:Anesthesiology, Controlled Before-After Studies, Cryoprecipitate, Blood coagulation disorders, Female, Fresh frozen plasma, business, Algorithms, medicine.drug
الوصف: Background Perioperative bleeding and transfusion are important causes of morbidity and mortality in patients undergoing liver transplantation. The aim of this study is to assess whether viscoelastic tests-guided therapy with the use of synthetic factor concentrates impact transfusion rates of hemocomponents in adult patients undergoing liver transplantation. Methods This is an interventional before-after comparative study. Patients undergoing liver transplantation before the implementation of a protocol using thromboelastometry and synthetic factor concentrates were compared to patients after the implementation. Primary outcome was transfusion of any hemocomponents. Secondary outcomes included: transfusion of red blood cells (RBC), fresh frozen plasma (FFP), cryoprecipitate or platelets, clinical complications, length of stay and in-hospital mortality. Results A total of 183 patients were included in the control and 54 in the intervention phase. After propensity score matching, the proportion of patients receiving any transfusion of hemocomponents was lower in the intervention phase (37.0 vs 58.4%; OR, 0.42; 95% CI, 0.20–0.87; p = 0.019). Patients in the intervention phase received less RBC (30.2 vs 52.5%; OR, 0.21; 95% CI, 0.08–0.56; p = 0.002) and FFP (5.7 vs 27.3%; OR, 0.11; 95% CI, 0.03–0.43; p = 0.002). There was no difference regarding transfusion of cryoprecipitate and platelets, complications related to the procedure, hospital length of stay and mortality. Conclusions Use of a viscoelastic test-guided transfusion algorithm with the use of synthetic factor concentrates reduces the transfusion rates of allogenic blood in patients submitted to liver transplantation. Trial registration This trial was registered retrospectively on November 15th, 2018 – clinicaltrials.gov – Identifier: NCT03756948. Electronic supplementary material The online version of this article (10.1186/s12871-018-0664-8) contains supplementary material, which is available to authorized users.
اللغة: English
تدمد: 1471-2253
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fe67f6e0bd77c8e215f77121aa165114
http://europepmc.org/articles/PMC6303918
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....fe67f6e0bd77c8e215f77121aa165114
قاعدة البيانات: OpenAIRE
الوصف
تدمد:14712253