{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:48:38Z","timestamp":1792511318753,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,7,25]],"date-time":"2011-07-25T00:00:00Z","timestamp":1311552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Massive transfusion (MTP) protocol design is hindered by lack of accurate assessment of coagulation. Rapid thrombelastography (r\u2010TEG) provides point\u2010of\u2010care (POC) analysis of clot formation. We designed a prospective study to test the hypothesis that integrating TEG into our MTP would facilitate goal\u2010directed therapy and provide equivalent outcomes compared to conventional coagulation testing.<\/jats:p><jats:p><jats:bold>STUDY DESIGN AND METHODS:<\/jats:bold> Thiry\u2010four patients who received more than 6 units of red blood cells (RBCs)\/6 hours who were admitted to our Level 1 trauma center after r\u2010TEG implementation (TEG) were compared to 34 patients admitted prior to TEG implementation (Pre\u2010TEG). Data are presented as mean\u2003\u00b1\u2003SEM.<\/jats:p><jats:p><jats:bold>RESULTS:<\/jats:bold> Emergency department pre\u2010TEG versus TEG shock, and coagulation indices, were not different: systolic blood pressure (94\u2003mmHg vs.101\u2003mmHg), temperature (35.3\u00b0C vs. 35.9\u00b0C), pH (7.16 vs. 7.11), base deficit (\u221213.0 vs. \u221214.7), lactate (6.5 vs. 8.1), international normalized ratio (INR; 1.59 vs. 1.83), and partial thromboplastin time (48.3 vs. 57.9). Although not significant, patients with Injury Severity Score range 26 to 35 were more frequent in the pre\u2010TEG group. Fresh\u2010frozen plasma (FFP)\u2003:\u2003RBCs, platelets\u2003:\u2003RBCs, and cryoprecipitate (cryo)\u2003:\u2003RBC ratios were not significantly different at 6 or 12 hours. INR at 6 hours did not discriminate between survivors and nonsurvivors (p\u2003=\u20030.10), whereas r\u2010TEG \u201cG\u201d value was significantly associated with survival (p\u2003=\u20030.03), as was the maximum rate of thrombin generation (MRTG; mm\/min) and total thrombin generation (TG; area under the curve) (p\u2003=\u20030.03 for both). Patients with MRTG of more than 9.2 received significantly less components of RBCs, FFP, and cryo (p\u2003=\u20030.048, p\u2003=\u20030.03, and p\u2003=\u20030.04, respectively).<\/jats:p><jats:p><jats:bold>CONCLUSION:<\/jats:bold> Goal\u2010directed resuscitation via r\u2010TEG appears useful for management of trauma\u2010induced coagulopathy. Further experience with POC monitoring could result in more efficient management leading to a reduction of transfusion requirements.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2011.03264.x","type":"journal-article","created":{"date-parts":[[2011,7,26]],"date-time":"2011-07-26T18:04:52Z","timestamp":1311703492000},"page":"23-33","source":"Crossref","is-referenced-by-count":108,"title":["Initial experiences with point\u2010of\u2010care rapid thrombelastography for management of life\u2010threatening postinjury coagulopathy"],"prefix":"10.1111","volume":"52","author":[{"given":"Jeffry L.","family":"Kashuk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest E.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Wohlauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pezold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter L.","family":"Biffl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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