Cotton et al used rapid thromboelastography (rTEG) to evaluate trauma patients. The r-TEG results on admission correlated with transfusion needs during the first 6 hours. The authors are from the University of Texas at Houston.
Patient selection: trauma
Early rapid thromboelastography results include:
(1) activated clotting time (ACT)
(2) k-time
(3) r-time
ACT
Transfusion Requirements
< 105 seconds (normal)
no transfusions within the first 6 hours (odds ratio 2.8)
105 to 128 seconds
intermediate risk
> 128 seconds
massive transfusion within the first 6 hours (odds ratio 5.2)
where:
• Massive transfusion was defined as >= 10 units RBCs).
• Table 5 uses first 6 hours for transfusion needs with ACT < 105. In abstract and editorial review it refers to first 24 hours.
For patients transfused blood within the first 24 hours, the 30-day mortality was 18%.
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