Minireviews
Copyright ©The Author(s) 2021.
World J Gastroenterol. Jun 21, 2021; 27(23): 3290-3302
Published online Jun 21, 2021. doi: 10.3748/wjg.v27.i23.3290
Table 2 Role of thromboelastography prior invasive procedures in cirrhosis
Ref.
Type of invasive procedure
Threshold for intervention
Transfusion
Blood products transfused (%)/total amount of FFP (mL) and PLT (units)
Bleeding complications (%)
No. of death
De Pietri et al[64] (2016)All invasive procedures (low and high risk)TEG: FFP R > 40 min; PLT MA < 30 mm. SOC: FFP INR > 1.8; PLT transfusion PLT < 50000/mmcTEG guided (n = 30); SOC (n = 30)TEG guided/SOC: All % 16/100; FFP % 0/53.3; PLT % 6.7/33.3; FP + PLT % 3/13.3. Low risk procedures: FFP (mL) 4000/11050; PLT (unit) 22/28. High risk procedures; FFP (mL) 0/6500; PLT (unit) 6/78TEG 0; SOC 3.3TEG 8; SOC 7; 90 d
Vuyyuru et al[71] (2020)All invasive procedures (low and high risk)TEG: FFP R > 14 min; PLT MA < 33 mm. SOC: FFP INR > 1.8; PLT transfusion PLT < 50000/mmcTEG guided (n = 29); SOC (n = 29)TEG guided/SOC: All % 27.6/96.6; FFP % 24/27; PLT % 10.3/75.9; FFP + PLT % 3.4/3.4TEG 0; SOC 0TEG 0; SOC 1; 28 d
Rout et al[72] (2020)Procedures for treating variceal bleedingTEG: FFP R > 15 min; PLT MA < 30 mm, SOC: FFP INR > 1.8; PLT transfusion PLT < 50000/mmcTEG guided (n = 30); SOC (n = 30) TEG guided/SOC: All % 13.3/100; FFP % 13.3/46.7; PLT% 10/70; FFP + PLT % 10/16.7; FFP (mL) 4000/11050; PLT (mL) 450/3450Rebleeding 5 d; TEG 3.3; SOC 13.3. Rebleeding 42 d; TEG 10; SOC 36.7TEG 13; SOC 26
Kumar et al[73] (2020)Procedures for treating nonvariceal bleedingTEG: FFP R > 10 min; PLT MA < 55 mm; CryoP angle < 45. SOC: FFP INR > 1.8; PLT transfusion PLT < 50000/mmc. CryoP Fibrinogen < 80 mg%TEG guided (n = 49); SOC (n = 47)TEG guided/SOC: All% 26.5/87.2; FFP 4.1/0; PLT% 4.1/0; FFP + PLT% 14.3/0; Cryo % 12.2/0; Cryo + PLT % 8.2/4.3; CryoP + FFP % 16.3/8.5; None% 14.3/0; FFP (mL) 440/880; PLT (unit) 1/2; CryoP (unit) 4/16Failure to control bleeding at 5 d. TEG 22.4; SOC 29.8. Failure to prevent bleeding after 5 d. TEG 50; SOC 57TEG 22.4; SOC 29.8; 5 d. TEG 55; SOC 66; 42 d
TEG: Thromboelastography; INR: International normalized ratio; SOC: Standard of care; FFP: Fresh frozen plasma; PLT: Platelets; CryoP: Cryoprecipitate.