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Coagulation support algorithm with rapid TEG and functional fibrinogen TEG in critical bleeding: more results and less time

Introduction

Early coagulation support is essential in massively bleeding patients. A Coagulation Support Algorithm (CSA), integrating rapid TEG (r-TEG) and functional fibrinogen TEG (ff-TEG) could shorten the time to a tailored treatment (Figure 1).

Figure 1
figure1

Coagulation Support Algorithm.

Methods

A retrospective comparison of the time to available TEG and Standard Coagulation Tests (SCT: INR, aPTTr, fibrinogen level) results in two groups of bleeding and coagulopathic patients using citrate kaolin-TEG (k-TEG) or the CSA protocol (r-TEG/ff-TEG). Statistical analysis was performed with Student's t test for unpaired samples.

Results

Twenty-three patients for each k-TEG and CSA group were compared. The time to available results was shorter using the CSA protocol in comparison with k-TEG (Table 1). The differences were both statistically (P < 0.00001) and clinically (mean reduction time 21 minutes) significant. SCT needed the longest time to obtain the final results.

Table 1 Comparison of time to results.

Conclusion

The implementation of a CSA, including r-TEG and ff-TEG, could shorten the time to a targeted treatment in critically bleeding patients.

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Blasio, E.D., Pellegrini, C., Federico, A. et al. Coagulation support algorithm with rapid TEG and functional fibrinogen TEG in critical bleeding: more results and less time. Crit Care 19, P352 (2015). https://doi.org/10.1186/cc14432

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Keywords

  • Public Health
  • Citrate
  • Emergency Medicine
  • Fibrinogen
  • Reduction Time
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