• J Clin Anesth · Apr 2020

    Review

    Viscoelastic haemostatic assays in the perioperative period of surgical procedures: Systematic review and meta-analysis.

    • André Soares Santos, Ananda Jessyla Felix Oliveira, Maria Carolina Lage Barbosa, and José Luiz Dos Santos Nogueira.
    • Centre for Health Technology Assessment of the UFMG Teaching Hospital (NATS-HC/UFMG), Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110, Santa Efigênia, 30.130-100 Belo Horizonte, Brazil.; Department of Economical Sciences, School of Economics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, 31.270-901 Belo Horizonte, Brazil. Electronic address: andresantos111@ufmg.br.
    • J Clin Anesth. 2020 Apr 13; 64: 109809109809.

    ObjectiveThe aim of this study is to evaluate the safety and efficacy of Viscoelastic Haemostatic Assays (VHA) to guide transfusions in patients undergoing surgical procedures.DesignSystematic review with meta-analysis of randomized controlled trials up until June 5, 2019.SettingHospitalized patients.InterventionsVHAs compared to the Standard-Of-Care (SOC), which are represented by standard laboratory tests and/or clinical decisions.MeasurementsPrimary - Risk of death, acute kidney injury, thrombotic events and reoperation for bleeding; Secondary - Risk of use of red blood cells (RBC), platelets, fresh frozen plasma (FFP), fibrinogen, factor VIIa, prothrombin complex, volume of RBC, platelets and FFP, length of hospital stay, and length of ICU stay.ResultsVHAs were associated to a statistically significant reduction in mortality (7.3% vs. 12.1%; RR = 0.64, p-value = 0.03), risk of acute kidney injury (10.5% vs. 17.6%; RR = 0.53, p-value = 0.005), volume of red blood cells (RBCs) transfused (MD = -1.63 U, p-value = 0.02), risk of platelet transfusion (23.9% vs. 27.3%; RR = 0.74, p-value = 0.006), risk of fresh frozen plasma (FFP) transfusion (RR = 0.57, p-value = 0.001), and volume of FFP transfused (MD = -0.90, p-value = 0.0003). No significant differences were observed in terms of thrombotic events, reexploration for bleeding, RBC transfusion, volume of platelets transfused, use of fibrinogen, prothrombin complex, or factor VIIa, length of hospitalization and length of ICU stay.ConclusionViscoelastic haemostatic assays are safe and efficacious for coagulation control in patients undergoing surgical procedures, therefore it should be considered for use in practice.Copyright © 2020 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…