Thromboelastography-Guided Blood Transfusion in Cirrhosis with Nonvariceal Bleeding

Viscoelastic hemostatic assays (VHAs), such as thromboelastography (TEG), are demonstrated to be more reliable than international normalized ratio (INR) and platelet count for assessing coagulation in patients with cirrhosis and can reduce utilization of blood products when used to guide transfusion requirements. Evidence comes from studies in patients undergoing liver transplantation, cardiac and abdominal surgeries, and other invasive procedures but not in those with nonvariceal bleeding.

In the current trial, researchers randomized 96 patients with cirrhosis and significant coagulopathy (defined as INR >1.8 and/or platelet count <50 x 10⁹/L) presenting with active nonvariceal bleeding (confirmed by esophagogastroduodenoscopy) to receive e…