Clinical Validation of Global Coagulation Tests to Guide Blood Component Transfusions in Cirrhosis and ACLF.
ACLF
Cirrhosis
Coagulation
Sonoclot
Thromboelastography
Validation
Journal
Journal of clinical and translational hepatology
ISSN: 2225-0719
Titre abrégé: J Clin Transl Hepatol
Pays: United States
ID NLM: 101649815
Informations de publication
Date de publication:
28 Apr 2021
28 Apr 2021
Historique:
received:
16
11
2020
revised:
06
01
2021
accepted:
20
01
2021
entrez:
19
5
2021
pubmed:
20
5
2021
medline:
20
5
2021
Statut:
ppublish
Résumé
Patients with cirrhosis and acute-on-chronic liver failure (ACLF) may have bleeding complications and need for invasive procedures. Point-of-care (POC) coagulation tests like thromboelastography (TEG) and Sonoclot may be better for guiding patient management than the standard coagulation tests (SCTs), like prothrombin time, platelet count and international normalized ratio. We prospectively compared and validated the POC tests and SCTs in 70 persons with ACLF and 72 persons with decompensated cirrhosis who had clinical bleeding and checked for episodes of re-bleeding and transfusion requirements. We assessed pre-procedure requirement of blood components when correction was done based on an SCT or POC strategy. Episodes of bleeding were seen in 45% and 28% of ACLF and cirrhosis patient, respectively ( Our study clinically validates that POC tests can better detect coagulation defects and transfusion thresholds in ACLF and cirrhosis, whereas use of conventional tests appear to be less suitable in patients with clinical bleeding. NCT04332484.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Patients with cirrhosis and acute-on-chronic liver failure (ACLF) may have bleeding complications and need for invasive procedures. Point-of-care (POC) coagulation tests like thromboelastography (TEG) and Sonoclot may be better for guiding patient management than the standard coagulation tests (SCTs), like prothrombin time, platelet count and international normalized ratio.
METHODS
METHODS
We prospectively compared and validated the POC tests and SCTs in 70 persons with ACLF and 72 persons with decompensated cirrhosis who had clinical bleeding and checked for episodes of re-bleeding and transfusion requirements. We assessed pre-procedure requirement of blood components when correction was done based on an SCT or POC strategy.
RESULTS
RESULTS
Episodes of bleeding were seen in 45% and 28% of ACLF and cirrhosis patient, respectively (
CONCLUSIONS
CONCLUSIONS
Our study clinically validates that POC tests can better detect coagulation defects and transfusion thresholds in ACLF and cirrhosis, whereas use of conventional tests appear to be less suitable in patients with clinical bleeding.
TRIAL REGISTRATION
BACKGROUND
NCT04332484.
Identifiants
pubmed: 34007803
doi: 10.14218/JCTH.2020.00121
pii: JCTH.2020.00121
pmc: PMC8111111
doi:
Banques de données
ClinicalTrials.gov
['NCT04332484']
Types de publication
Journal Article
Langues
eng
Pagination
210-219Informations de copyright
© 2021 Authors.
Déclaration de conflit d'intérêts
The authors have no conflict of interests related to this publication.
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