Influence of the tactics of intensive therapy of hemostatic disorders on intraoperative blood transfusion requirements and course of postoperative period following liver transplantation
Objectives. To compare the efficiency of intensive therapy of hemostatic disorders based on thromboelastometric data with the efficiency of intensive therapy of hemostatic disorders according to standard coagulation tests results. Methods. 70 patients who underwent liver transplantation were enrolled in the study. Patients were randomized into two groups. The study group comprised of 35 patients to whom hemostatic abnormalities were corrected according to the thromboelastometric data, the control group comprised of 35 patients to whom hemostatic abnormalities were corrected according to standard coagulation tests results. Results. Intensive therapy of hemorrhagic syndrome based on thromboelastometric data permits to reduce the blood loss from 1800 (1300-2000) ml to 1200 (1000-1700) ml and the amount of transfusions of RBCand FFP from 1447 (920-2120) ml and 2600 (2000-3400) ml to 1056 (692-1286) ml and 500 (0-1200) ml, respectively. Reduction of blood transfusions has led to decrease of the incidence of acute kidney injuries (from 88,6% to 65,7%) and shortening of the length of stay in intensive care units (from 6 to 5 days) and in the hospital (from 18 to 16 days). Conclusions. The study confirmed the high efficiency of intensive therapy of hemostasis disorders based on thromboelastometric data compared with intensive therapy of hemostasis disorders based on the results of standard coagulation tests.