Liver Cirrhosis
Conditions
Keywords
THROMBOELASTOGRAPHY, THROMBOELASTOMETRY, nonvariceal, bleeding
Brief summary
Studies comparing Thromboelastography or Rotational thromboelastometry versus standard coagulation tests are abundant. Data comparing the two exclusively in a liver intensive care set up is limited. Studies show that TEG and ROTEM cannot be used interchangeably in trauma, liver transplant patients, but there is limited evidence of the same in critically ill cirrhotic patients. In this study, the investigators tried to demonstrate the comparison of blood products used to treat coagulopathy based on TEG versus ROTEM algorithms in cirrhotic patients presenting with non variceal bleeding
Detailed description
Thromboelastography (TEG) and thromboelastometry( ROTEM) are point-of-care, global hemostasis assessment tests that measure the viscoelastic changes that occur during the hemostatic process. Patients with cirrhosis have an imbalance of procoagulants and anticoagulants combined with alterations in fibrinolysis ,platelet number and function. Point of care viscoelastic tests (TEG ,ROTEM) demonstrate specific functional coagulation defects that can direct blood component transfusion therapy in cirrhosis, with clinical validation of individual parameters. Studies comparing Thromboelastography or Rotational thromboelastometry versus standard coagulation tests are abundant. Data comparing the two exclusively in a liver intensive care set up is limited. Studies show that TEG and ROTEM cannot be used interchangeably in trauma, liver transplant patients, but there is limited evidence of the same in critically ill cirrhotic patients. In this study, the investigators tried to demonstrate the comparison of blood products used to treat coagulopathy based on TEG versus ROTEM algorithms in cirrhotic patients presenting with non variceal bleeding
Interventions
None listed
Sponsors
Institute of Liver and Biliary Sciences, India
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* patients of liver cirrhosis with non variceal bleed
Exclusion criteria
1. Pregnant and postpartum patients 2. died within the first 24hours of admission. 3. variceal and postvariceal ligation ulcer bleed. 4. On anticoagulants or antiplatelets at the time of admission in ICU 5. Transfusion with blood products before admission to the ICU.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total amount of blood products transfused at 8 hours(FFP, Cryoprecipitate, platelets) will be measured | 8 hours | Total amount of blood products transfused at 8 hours(FFP, Cryoprecipitate, platelets) will be measured |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| K time of thromboelastography | 8 hours | K time represents time until clot reaches a fixed strength |
| alpha angle of thromboelastography | 8 hours | alpha angle represents speed of fibrin accumulation |
| Maximum amplitude of thromboleastography | 8 hours | It represents the highest vertical amplitude of thromboelastography |
| LY30 Iin thromboelastometry | 8 hours | It represents the percentage of amplitude reduction 30 minutes after reaching maximum amplitude |
| R time of thromboelastography | 8 hours | R time measures time to start forming clot |
| Clot formation time in thromboelastometry | 8 hours | It represents the clot strengthening and rapidity of fibrin build up |
| Maximum clot firmness in thromboelastometry | 8 hours | It represents the highest vertical amplitude of the thromboelastometry graph and represents clot strength |
| LI30 in thromboelastometry | 8 hours | It represents clot breakdown and fibrinolysis at fixed time |
| Control of bleeding at 48 hours | 48 hours | The investigators would measure the hemoglobin levels to see for any drop in concentration of hemoglobin |
| Clotting time in thromboelastometry | 8 hours | It represents the time to start forming clot and initial fibrin formation |
Countries
India
Outcome results
None listed