METHODS: We searched PubMed, ScienceDirect, Google Scholar, and grey literature using terms meaning viscoelastic testing and cirrhosis. After reviewing over 500 titles and abstracts, 40 full-text papers met inclusion criteria.
RESULTS: Twenty-two papers found viscoelastic testing was a better indicator of baseline coagulation than traditional testing in cirrhosis. Nineteen additional papers evaluated the utility of peri-procedural viscoelastic testing and found they led to a reduction in blood product administration without increasing risk of hemorrhage, thrombotic events, or other complications.
CONCLUSIONS: The usage of viscoelastic testing in patients with cirrhosis allows for better assessment of coagulopathy, resulting in improved outcomes. Educating physicians to optimize care of this high-risk group is necessary to further improve their treatment.
方法:我们搜索了PubMed,ScienceDirect,谷歌学者,和灰色文献使用术语表示粘弹性测试和肝硬化。在审查了超过500个标题和摘要后,40篇全文论文符合纳入标准。
结果:22篇论文发现粘弹性测试比传统的肝硬化测试是更好的基线凝血指标。另外19篇论文评估了围手术期粘弹性测试的实用性,发现它们导致了血液制品给药的减少,而不会增加出血的风险。血栓形成事件,或其他并发症。
结论:在肝硬化患者中使用粘弹性测试可以更好地评估凝血病,从而改善结果。教育医生优化对这一高危人群的护理对于进一步改善他们的治疗是必要的。