Utility of rotational thromboelastometry in the management of massive haemorrhage at a regional Australian hospital.

IF 1.5 4区医学 Q3 HEMATOLOGY

Transfusion Medicine Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI:10.1111/tme.13018

Yu-Hsuan Liu, Jessica Sia, Azhar Munas, Catherine Tacon, Kris Salaveria, Harrison Langa Lutshaba, Josh Hanson

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引用次数: 0

Abstract

Background: Rotational thromboelastometry (ROTEM) allows targeted and individualised blood product replacement.

Objectives: The study aimed to determine the impact of ROTEM-guided transfusion on the clinical course of patients with acute massive haemorrhage in a regional Australian hospital.

Methods/materials: A retrospective review of all patients with acute massive haemorrhage that compared the characteristics, blood product use, and clinical outcomes of patients with massive haemorrhage before and after the introduction of ROTEM-guided transfusion.

Results: In per-protocol analysis, the 31/97 (32%) with ROTEM-guided transfusion used less packed red blood cells (median [interquartile range]: 6 [6-8] vs. 8 [6-12] units, p = 0.03) than patients whose transfusion was not ROTEM-guided. They were also less likely to receive fresh frozen plasma (2/31 [6%] vs. 45/66 [68%], p < 0.0001) or platelets (2/31 [6%] vs. 31/66 [47%], p < 0.0001); they were, however, more likely to receive fibrinogen products (26/31 [84%] vs. 38/66 [58%], p = 0.01). Patients receiving ROTEM-guided transfusion had lower in-hospital mortality (6/31 [19%] vs. 20/66 [30%], odds ratio 0.55 [95% confidence interval]: 0.20-1.55, p = 0.26) although this did not achieve statistical significance in this small cohort.

Conclusion: ROTEM-guided massive transfusion of patients with acute haemorrhage in this regional Australian hospital led to a reduction in packed red blood cell, fresh frozen plasma, and platelet utilisation and may also have reduced mortality.

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旋转血栓弹性测量术在澳大利亚一家地区医院大出血治疗中的应用。

背景:旋转血栓弹性测量(ROTEM)允许有针对性和个性化的血液制品替代。目的:本研究旨在确定rotem引导输血对澳大利亚一家地区医院急性大出血患者临床病程的影响。方法/材料:回顾性分析所有急性大出血患者，比较大出血患者在引入rotem引导输血前后的特征、血液制品使用和临床结果。结果:在每个方案分析中，31/97(32%)接受rotem引导输血的患者使用较少的红细胞(中位数[四分位数范围]:6[6-8]对8[6-12]单位，p = 0.03)比不接受rotem引导输血的患者。他们接受新鲜冷冻血浆的可能性也较低(2/31[6%]对45/66[68%])。结论:在澳大利亚的这家地区医院，rotem引导下的急性出血患者大量输血导致红细胞、新鲜冷冻血浆和血小板利用率降低，也可能降低死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion Medicine 医学-血液学

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Transfusion Medicine publishes articles on transfusion medicine in its widest context, including blood transfusion practice (blood procurement, pharmaceutical, clinical, scientific, computing and documentary aspects), immunohaematology, immunogenetics, histocompatibility, medico-legal applications, and related molecular biology and biotechnology. In addition to original articles, which may include brief communications and case reports, the journal contains a regular educational section (based on invited reviews and state-of-the-art reports), technical section (including quality assurance and current practice guidelines), leading articles, letters to the editor, occasional historical articles and signed book reviews. Some lectures from Society meetings that are likely to be of general interest to readers of the Journal may be published at the discretion of the Editor and subject to the availability of space in the Journal.