Blood Product Utilization in Thromboelastography-Aided Transfusion in Gastrointestinal Bleeding: A Single-Center...

Area of Science:

• Critical Care Medicine
• Hematology
• Gastroenterology

Background:

• Gastrointestinal bleeding (GIB) is a frequent cause of intensive care unit (ICU) admission with high mortality.
• Effective resuscitation is critical before procedural interventions for GIB.
• Thromboelastography (TEG) assesses coagulation but its role in GIB management is debated.

Purpose of the Study:

• To evaluate the clinical utility of TEG during resuscitation for GIB.
• To assess the impact of TEG on blood product usage and patient outcomes in GIB.

Main Methods:

• Retrospective study of ICU patients undergoing TEG during GIB resuscitation (2017-2020).
• Patient data identified via ICD-10 codes and blood bank records.
• Analysis of demographics, comorbidities, resuscitation parameters, blood product transfusion, ICU stay, and mortality.

Main Results:

• A cohort of 226 patients (mean age 61) with GIB was analyzed.
• Common comorbidities included alcoholic liver disease and esophageal varices.
• Patients received a median of 5 packed red blood cells (pRBC) and 1 fresh frozen plasma (FFP).
• Observed mortality rate was 39% despite TEG use.

Conclusions:

• TEG's benefit in reducing transfusions for GIB is uncertain due to high mortality.
• Further research is required to determine the efficacy of TEG-guided transfusion strategies in GIB patients.