UNASSIGNED: Bleeding is a feared complication of invasive procedures in @entity1 with @entity82 and @entity1003 (as defined by routine coagulation tests) and is used to justify preprocedure use of fresh frozen plasma (FFP) and/or platelets ( @entity49683 ). Thromboelastography (TEG) provides a more @entity1650 assessment than routine tests (international normalized ratio [INR] and platelet count), and its use may avoid unnecessary blood product transfusion in @entity1 with @entity82 and @entity1003 (defined in this study as INR >1.8 and/or platelet count <50 * 10(9) /L) who will be undergoing an invasive procedure. Sixty @entity1 were randomly allocated to TEG-guided transfusion strategy or standard of care (SOC; 1:1 TEG:SOC). The TEG group would receive FFP if the reaction time (r) was >40 min and/or @entity49683 if maximum amplitude (MA) was <30 mm. All SOC @entity1 received FFP and/or @entity49683 per hospital guidelines. Endpoints were blood product use and @entity548 complications. Baseline characteristics of the two groups were similar. Per protocol, all subjects in the SOC group received blood product transfusions versus 5 in the TEG group (100% vs. 16.7%; P   <   0.0001). Sixteen SOC (53.3%) received FFP, 10 (33.3%) @entity49683 , and 4 (13.3%) both @entity49683 . In the TEG group, none received FFP alone (P   <   0.0001 vs. SOC), 2 received @entity49683 (6.7%; P   =   0.009 vs. SOC), and 3 both @entity49683 (not significant). Postprocedure @entity548 occurred in only 1 @entity1 (SOC group) after large-volume paracentesis. CONCLUSIONS: In @entity1 with @entity82 and @entity1003 before invasive procedures, TEG-guided transfusion strategy leads to a significantly lower use of blood products compared to SOC (transfusion guided by INR and platelet count), without an increase in @entity548 complications. Remarkably, even in @entity1 with @entity1003 , postprocedure @entity548 was rare, indicating that TEG thresholds should be reevaluated. (Hepatology 2016;63:566-573).

Thrombelastography-guided blood product use before invasive procedures in XXXX with severe @entity1003 : A randomized, controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity49683 :: ('27163', 'Gene') :: ['FFP and PLT', 'PLT'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity1650 :: ('MESH:D001308', 'Disease') :: ['comprehensive global coagulation'] @entity1003 :: ('MESH:D001778', 'Disease') :: ['significant coagulopathy']
@entity82 :: (MESH:D005355,Disease) :: ['cirrhosis']
