Clinical Observation Of The TEG Used To Guide The Plasma Transfusion In Patients With Massive Transfusion

Objective:Thrombelastograph(TEG)was used to monitor the dynamic changes of coagulation function in patients with massive transfusion(MT)continuously and as a basis to guide the transfusion of fresh frozen plasma(fresh frozen plasma,FFP).Explore the role of TEG in the monitoring the coagulation function in patients with massive transfusion and guide the individualized precise plasma infusion regimen.Methods:Select 90 patients period the operation receiving massive transfusion from May,2015 to December,2016.Divide the patients into 3 groups: the high plasma transfusion group(Team D),30 patients,RBC:FFP=1:1;the low plasma transfusion group(Team S),20 patients,RBC:FFP=2:1.(1U RBC:100ml FFP=1:1);the TEG-guided plasma transfusion group,40 patients(Team T).Record the immediate TEG parameters at the termination of infusing the blood product,the amount of bleeding,the input amount of FFP and RBC and the input amount of crystal liquids and colloidal liquids.The outcome was analyzed by SPSS22.0.P<0.05 was considered as statistically significant.Results:Three groups of patients were not statistically significant in age,gender,stature and the ASA grade(p>0.05).Three groups of patients were not statistically significant in the amount of bleeding,the input amount of RBC,the input amount of crystal liquids and colloidal liquids.Comparing of the amount of FFP transfusion in surgery,Team D was obviously more than Team S and Team T.There was a significant difference(p<0.05).There was not significant in comparison of Team T and Team S(p>0.05).There were obvious changes in the R?K?? and MA between high plasma transfusion group and low plasma transfusion group,between the TEG-guided plasma transfusion group and low plasma transfusion group,respectively.In comparison with other two groups,R,K both increased and ?,MA decreased in the low plasma transfusion group.The differences in values of R?K???and MA between the high plasma transfusion group and the TEG-guided plasma transfusion group were not statistically significant.Conclusion:1.Considering the amount of plasma transfusion,the amount of FFP transfusion in the TEG-guided plasma transfusion group was less than the high plasma transfusion group.It avoided the waste of the blood product unnecessarily.2.From the coagulation function comparison,the effect of coagulation function in the TEG-guided plasma transfusion group and the high plasma transfusion group was better than the low plasma transfusion group,to maintain the coagulation status relatively stable.3.The TEG-guided plasma transfusion group of red blood cells and plasma infusion ratio concentrated in(1 ~ 2): 1.4.It is appropriate that the TEG directs the FFP transfusion in patients with massive transfusion.The TEG is able to offer an individualized plasma infusion regimen.