Clinical study on thromboelastography-indicated postoperative blood requirements after abdominal surgery

Objective To investigate the accuracy and promptness of thromboelastography (TEG) to assess the blood transfusion requirements after abdominal operation in comparison with conventional assessments including vital signs (MAP,heart rate,breathing rate),urine output,hemoglobin and hematocrit.Methods From June to December in 2010,there were 57 patients were suspected bleeding in abdominal cavity after operation in SICU.Recorded data including vital signs (MAP,heart rate,breathing rate,oxygen saturation),urine volume per hour,the coagulation tests (Fib,PT,aPTT,INR),TEG parameters (R,K,Angle,MA,CI),the results of blood routine (Hb,Hct,Ph) and whether bleeding or not,blood product requirements within 24 h.Results Vital signs (MAP,heart rate,breathing rate,oxygen saturation),urine output per hour and the coagulation tests (Fib,PT,INR) showed no significant correlations (P ＞ 0.05) with blood transfusion requirements,but aPTT (R =0.513,P =0.000) and MA (R =0.578,P =0.000) correlated with the blood transfusion requirement.Patients with reduced MA needed more blood transfusion requirements.Patients were divided into active bleeding group and insidious bleeding group.MA had significant difference between two groups (P =0.025),but aPTT had not.Conclusions Thrombelastography is a more accurate indicator of blood transfusion requirements,especially in active bleeding patients. Key words: Thrombelastography ;  Traditionary coagulation tests ;  Abdominal surgery ;  Bleeding; Active bleeding;  Transfusion;  Blood product requirements