Establishment Of Reference Values For Kaolin-activated Thromboelastography (TEG) And Its Application Of In Guiding Blood Transfusion After Cardiac Valve Replacement

Objective The assessment of the coagulation status using thromboelastography(TEG)in Chinese population has less been reported.This study aimed to establish reliable reference values for kaolin-activated TEG in Chinese volunteers.Methods A total of 1681 Chinese adult individuals were recruited for this study.The reference individuals were stratified by gender and age,and the TEG values were measured on the basis of strict quality control.The 95% reference values were determined using nonparametric statistical methods.Results The sex-related 95% reference values were reaction time(R):4.2–8.7 min;clotting time(K): 1.2 – 3.2 min;alpha angle(α): 47.0 – 72.3 degree;maximum amplitude(MA): 49.1–70.5 mm for males,and R: 3.7–9.0 min;K: 1.0–3.2 min;α:48.4 – 74.4 degree;MA: 46.8 – 72.4 mm for females.Also,the TEG parameters indicated a relatively more hypercoagulable profile in both female and elder groups.Conclusion This study established the reference values for kaolin-activated TEG in the target Chinese population,which might provide a reference for both clinical and laboratory studies.Objective To evaluate the value of thromboelastography(TEG)in the adult patients undergoing cardiac valve replacement during the intensive care unit.Methods A total of 118 patients presenting for cardiac valve replacement were randomised to either TEG(62/118)or SCT(56/118)groups.According to the choice of different blood transfusion guidelines based on standard coagulation tests(SCT)or TEG,the physician directed product administration with reference to respective parameters.The differences of demographic characteristics,perioperative laboratory test,intraoperative blood transfusion were compared between groups,as were outcomes metrics such as the intubation time,thoracicd rainage,length of ICU stay.The focus was on the usage of different blood products between the two groups during the intensive care unit.Results Demographic characteristics,perioperative laboratory test and blood transfusion in cardiopulmonary bypass were similar between groups.When in ICU,TEG patients saw a substantial reduction in the administration of fresh frozen plasma(P <0.01)transfusions.TEG-based management reduced platelet(P=0.086)usage but this was not statistically significant.There was no significant difference in red blood cell(P>0.05)transfusion between the two groups.This was associated with a statistically insignificant trend towards better short-term outcomes.Conclusion This retrospective investigation suggests that a protocol for blood transfusion based on the TEG might be highly effective in reducing usage of plasma and platelet without impairing short-term outcome in patients after cardiac valve replacement during ICU.