Rotational thromboelastometry guided blood component administration

Introduction: Rotational thromboelastometry is a diagnostic tool extensively utilized for patients at high risk of bleeding, particularly those experiencing trauma or undergoing significant surgical procedures. This test is notable for providing rapid results, facilitating timely decisions regarding the application of individualized transfusion therapies, thereby optimizing the rational use of blood components. Aim: The objective of this study is to assess the utilization of blood components in the transfusion treatment of patients at the Emergency Center of the University Clinical Center of Serbia, based on the outcomes of rotational thromboelastometry. The analysis aims to evaluate the frequency of these interventions in the studied population and to highlight the advantages of this treatment modality. Material and methods: This retrospective study analyzed trauma patients who underwent rotational thromboelastometry at the Hospital Blood Bank, Department of Pre-transfusion Testing, Emergency Center of the University Clinical Center of Serbia, from January 1st 2023, to December 31st 2023. Data regarding the results of the thromboelastometry tests and subsequent blood component therapies were extracted from the Service's protocols. Results: During the study period, 776 patients were evaluated by means of rotational thromboelastometry, of which 358 (46.13%) required blood component therapy. Cryoprecipitate was administered to 48 (13.40%) patients, platelet concentrate to 69 (19.27%), and a combination of cryoprecipitate and platelets to 61 (17.03%) patients. Additional therapeutic approaches included the administration of platelets, desmopressin, and tranexamic acid, while fresh frozen plasma was utilized the least, in only 17 (4.74%) patients. Conclusion: The analysis of blood components used for therapeutic purposes in relation to the rotational thromboelastometry demonstrated a wide range of therapeutic modalities in the treatment of patients. This testing method facilitates individualized therapy with blood components, subsequently diminishing the need for transfusions, enhancing diagnostic precision, and reducing costs associated with long-term management of patients.