{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:55:41Z","timestamp":1792839341127,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Thromboelastography (TEG) provides a more comprehensive global coagulation assessment than routine tests (international normalized ratio [INR] and platelet [PLT] count), and its use may avoid unnecessary blood component transfusion in patients with advanced cirrhosis and significant coagulopathy who have nonvariceal upper gastrointestinal (GI) bleeding. A total of 96 patients with significant coagulopathy (defined in this study as INR\u00a0&gt;1.8 and\/or PLT count\u00a0&lt;\u00a050\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L) and nonvariceal upper GI bleed (diagnosed after doing upper gastrointestinal endoscopy, which showed ongoing bleed from a nonvariceal source) were randomly allocated to TEG\u2010guided transfusion strategy (TEG group; n\u00a0=\u00a049) or standard\u2010of\u2010care (SOC) group (n\u00a0=\u00a047). In the TEG group, only 26.5% patients were transfused with all three blood components (fresh frozen plasma [FFP], PLTs, and cryoprecipitate) versus 87.2% in the SOC group (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). Although 7 (14.3%) patients in the TEG group received no blood component transfusion, there were no such patients in the SOC group (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.012). Also, there was a significantly lower use of blood components (FFP, PLTs, and cryoprecipitate) in the TEG group compared with the SOC group. Failure to control bleed, failure to prevent rebleeds, and mortality between the two groups were similar. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> In patients with advanced cirrhosis with coagulopathy and nonvariceal upper GI bleeding, TEG\u2010guided transfusion strategy leads to a significantly lower use of blood components compared with SOC (transfusion guided by INR and PLT count), without an increase in failure to control bleed, failure to prevent rebleed, and mortality.<\/jats:p>","DOI":"10.1002\/hep.30794","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T08:45:08Z","timestamp":1559292308000},"page":"235-246","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":169,"title":["Thromboelastography\u2010Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial"],"prefix":"10.1097","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3448-8334","authenticated-orcid":false,"given":"Manoj","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juned","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi","family":"Maiwall","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute 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Agarwal","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chhagan","family":"Bihari","sequence":"additional","affiliation":[{"name":"Department of Pathology,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saggere Muralikrishna","family":"Shasthry","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Jindal","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Liver Transplantation,Institute of Liver & Biliary Sciences,New 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