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How do we integrate thromboelastography with perioperative transfusion management?

Department of Anesthesiology, University of Kentucky, Lexington, Kentucky, United States
Transfusion (Impact Factor: 3.57). 06/2012; 53(7). DOI: 10.1111/j.1537-2995.2012.03728.x
Source: PubMed
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    ABSTRACT: Despite recent advances in the understanding and treatment of coagulopathy, the management of the bleeding patient remains as a major challenge. Traditionally, the main task of the blood bank has been to guarantee the supply of high quality blood and blood components/products to the hospital. Decisions regarding the use of blood components have always been the clinicians' responsibility, with little active involvement of the transfusion service. In the last years, many hospitals have implemented the use of "acute transfusion packages" for massively bleeding patients and point-of-care (POC) instruments such as TEG and RoTEM for monitoring coagulation status in this patient group. This, in addition to the implementation of patient blood management programs in the hospitals, has led to an increasing involvement of transfusion medicine specialists in transfusion decision making, especially regarding strategies for monitoring and treatment of the massively bleeding patient. This new trend may contribute to a more optimal management and monitoring of the bleeding patient, as POC testing may be used as an early predictor for blood usage. The blood bank should optimise the use of POC testing to provide accurate information in a cost-effective way. Copyright © 2014. Published by Elsevier Ltd.
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