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Role of Using a Thromboelastometry-Based Protocol for Transfusion Management in Combined Coronary Artery Bypass Grafting and Valve Surgery: A Randomized Clinical Trail

Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran. GRID: grid.418552.f Departments of Immunology, Faculty of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran. GRID: grid.412266.5. ISNI: 0000 0001 1781 3962 Cardiac Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. GRID: grid.411746.1. ISNI: 0000 0004 4911 7066 Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, IranTehran, Iran. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Mellat park, Valiasr Avenue, Tehran, Iran. GRID: grid.411746.1. ISNI: 0000 0004 4911 7066 Coagulation Laboratory, Iranian Blood Transfusion Organization, Tehran, Iran.

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion. 2021;37(3):422-429
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Abstract
The aim of this study was to evaluate the impact of using a thromboelastometry-based protocol on transfusion requirements in patients undergoing combined coronary artery bypass grafting (CABG) and valve surgery. 80 adult patients scheduled for elective combined CABG and valve surgery were included in this clinical trial study. Patients were randomly allocated to the thromboelastometry (ROTEM) (n = 40) or control groups (n = 40). In the ROTEM group, transfusion was directed according to a thromboelastometry-based protocol. In the control group, transfusion was conducted according to the routine practices including conventional coagulation testing and clinical judgments. Finally, transfusion requirements were compared between groups. Use of thromboelastometry- based protocol resulted in 67% reduction in blood products units' consumption as well as 23% in the percentage of patients transfused. This reduction was especially evident in relation to fresh frozen plasma (FFP) and platelet consumption. No significant differences were found both in the percentage of patients receiving RBC and number of transfused RBC units. Using thromboelastometry tests incorporated a protocol results in reduction of transfusion requirements in patients undergoing elective combined CABG and valve surgery.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine