Rotational Thromboelastometry [ROTEM] vs Thromboelastography [TEG] Guided Blood Component Use in Patients With Cirrhosis of Liver With Non-variceal Bleeding.

AIM:- To compare Rotational thrombo- elastometry vs Thrombo- elastography as a guide for blood component transfusion in patients of Cirrhosis with nonvariceal bleeding.

Methodology:- After fulfilling all inclusion and exclusion criteria, patients were randomized to either the TEG or ROTEM group in a 1:1 proportion. Patients in the TEG group received blood components using the following triggers: FFP at a dose of 10 mL/kg of ideal body weight when reaction time (R time) was greater than 10 minutes; a single-donor apheresis platelet (SDAP) unit, which corresponds to approximately 6 to 8 pooled units of PLTs, transfused when the maximum amplitude (MA) was less than 55 mm; and cryoprecipitate (5 pooled units) transfused when the alpha angle was less than 45°.In ROTEM group if CT EXTEM \>80S FFP at dose of 10ml/kg or PCC 20-25IU/kg ,if MCF EXTEM \<35 and MCF FIBTEM \<8 CRYO or Fibrinogen concentrate, if MCF EXTEM\<35 and MCF FIBTEM \>8 Platelet, CL LY\>50 Trenaxemic acid

Study population: patients with Cirrhosis of liver with nonvariceal bleeding Study design: Randomized controlled trial Study period: 1 years after ethical clearance

Sample size: Assuming that total volume of FFP used in TEG 760 ± 370 and further in ROTEM volume used 510±275 with α 5% power 90, we need to enrol 72 cases. Further assuming 10% inadequacy We had decided to enroll a total of 80 patients, 40 in each group.The allocation will be done randomly by block randomization method.

Monitoring and assessment: All the parameters of the objective and also noted any adverse effects.

STATISTICAL ANALYSIS:

The data will be entered in Microsoft excel and will be analyzed using SPSS version 22. The categorical data will be analyzed using Chi square/Fissure test. Exact test and continuous data will be compiled using t-test. Besides this the univariate and multivariate survival analysis will be carried out using Cox regression method. Kaplan-Meier technique will be applied for further analysis. P-value\<0.05 will be considered as significant.

Adverse effects:Transfusion related complication

Stopping rule: If patient decided to withdraw from study

• Cumulative volume of Cryoprecipitate in both groups [Срок оценки: 6 weeks]
• Cumulative volume of Platelet in both groups [Срок оценки: 6 weeks]
• Cumulative volume of Trenaxemic acid Transfusion related reactions in both groups [Срок оценки: 6 weeks]
• Duration of intensive care unit (ICU) in both groups [Срок оценки: 6 weeks]
• Duration of hospital stay in both groups [Срок оценки: 6 weeks]
• Survival in both groups at 6 weeks [Срок оценки: 6 weeks]