Evaluation of Thromboelastometry in Sepsis in Correlation With Bleeding During Invasive Procedures

Area of Science:

• Coagulation Medicine
• Critical Care

Background:

• Sepsis frequently causes prolonged prothrombin time (PT).
• Thromboelastometry, a global coagulation test, may show normal results in sepsis.
• The clinical significance of prolonged PT with normal thromboelastometry in sepsis is unclear.

Purpose of the Study:

• To investigate if prolonged PT and normal thromboelastometry correlate with severe bleeding in sepsis patients undergoing invasive procedures.

Main Methods:

• Retrospective analysis of 76 sepsis patients undergoing low or high-risk bleeding invasive procedures between 2013-2016.
• Coagulation assessed using thromboelastometry (EXTEM test) and PT (INR/PR).
• Severe bleeding occurrence monitored during procedures and 24 hours post-procedure.

Main Results:

• Patients with prolonged PT (median INR 1.59, PR 1.5) and normal thromboelastometry showed no severe bleeding during procedures.
• Sepsis can present with prolonged PT despite normal global coagulation tests.

Conclusions:

• Prolonged PT with normal thromboelastometry in sepsis patients undergoing invasive procedures is not associated with severe bleeding.
• This coagulation assessment strategy may help avoid unnecessary fresh frozen plasma administration.