Cirrhosis, Coagulopathy
Conditions
Brief summary
Cirrhosis results in decreased synthesis of both procoagulants and anticoagulants resulting in rebalanced homeostasis. However, conventional blood tests (platelets/ INR levels) that are performed prior to invasive procedures do not accurately reflect the coagulation changes that occur in cirrhotics, resulting in unnecessary transfusion of blood products. Thromboelastography (TEG) is a global hemostasis assessment tool that is being used in surgery (including liver transplant) to help guide blood product transfusion in the operating room. The investigators would like to compare the use of TEG vs. INR/platelets to help guide blood product transfusion in cirrhotic patients undergoing inpatient endoscopy. The investigators will evaluate to see if there is a decrease in prophylactic blood transfusions prior to endoscopy when using TEG.
Interventions
BIOLOGICALBlood transfusion
Sponsors
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All 18 yo + cirrhotic patients who are being scheduled for inpatient endoscopy
Exclusion criteria
* Patients on blood thinners (prophylactic anticoagulation is permissible) * Hemodynamically unstable patients requiring pressors (ie ICU level patients) * Pregnant or lactating individuals * Inability to provide consent for any reason
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Units of fresh frozen plasma (FFP) and platelet transfused | 2 week | Will compare how much FFP and platelet transfusion patients receiving between 2 groups. |
Outcome results
None listed