Thromboelastography characteristics in critically ill patients with liver disease
Recommended Citation
Bajwa RK, Kleb C, Faisal MS, Khan MZ, Khan A, Lyu R, Angelini D, Sims OT, and Modaresi Esfeh J. Thromboelastography characteristics in critically ill patients with liver disease. Eur J Gastroenterol Hepatol 2024; 36(2):190-196.
Document Type
Article
Publication Date
2-1-2024
Publication Title
European journal of gastroenterology & hepatology
Abstract
OBJECTIVE: The purpose of this study was to determine how thromboelastography (TEG) parameters differ by various clinical conditions that commonly occur in patients with cirrhosis, including sepsis, acute on chronic liver failure (ACLF), alcohol-associated hepatitis (AAH) and portal vein thrombosis (PVT).
BACKGROUND: TEG, a whole blood assay, is used to assess several parameters of coagulation and is becoming increasingly used in clinical practice.
STUDY: This study was a retrospective chart review of 155 patients admitted to the ICU with decompensated cirrhosis from 2017 to 2019.
RESULTS: The R time was significantly shorter in patients when they were septic compared to when they were not and longer in patients with vs. without ACLF grade 3. Alpha angle and maximum amplitude was decreased in patients with severe AAH compared to those without severe AAH; and maximum amplitude was increased in patients with acute PVT compared to those with chronic PVT. R time was positively correlated with Chronic Liver Failure Consortium Organ Failure and Chronic Liver Failure Consortium ACLF scores (rho = 0.22, P = 0.020), while alpha angle and maximum amplitude were negatively correlated with MELD-NA.
CONCLUSION: Findings suggest TEG parameters vary in several clinical conditions in patients with decompensated cirrhosis who are admitted to the ICU. Prospective research is needed to confirm our findings and to determine how this knowledge can be used to guide clinical practice, as well as blood product transfusions in the setting of bleeding or prior to invasive procedures.
Medical Subject Headings
Humans; Thrombelastography; Retrospective Studies; Prospective Studies; End Stage Liver Disease; Critical Illness; Liver Cirrhosis; Acute-On-Chronic Liver Failure
PubMed ID
38131425
Volume
36
Issue
2
First Page
190
Last Page
196
