Coagulation functions in a large-dose blood loss/transfusion model by different protocols in vitro / 中国输血杂志

ABSTRACT

【Objective】 To evaluate common laboratory items in a large-dose blood loss model in vitro using thromboelastogram (TEG), to provide a reasonable infusion solution for clinical massive transfusions. 【Methods】 On March 2nd, 2017, eight healthy blood donors who participated in voluntary blood donation in the Department of Blood Transfusion Medicine of the First Medical Center of the PLA General Hospital were selected to undergo phlebotomy, and an in vitro dilution model of massive blood loss was established based on the previous research, namely Model 1 (M1, given massive transfusion protocol) and Model 2 (M2, given packed red blood cells and plasma) were established. Then blood routine, routine coagulation function, clotting factor activity, TEG of each model were tested. 【Results】 The platelet count in the M1 model was 61.00±10.24 (×109/L), and reduced to 28.83±10.36(×109/L) in M2 (P<0.01). The MA value (mm) of two groups detected by TEG was 29.35±2.37 vs 20.53± 2.76 (P<0.01). In M1 and M2 model, The activities of primary clotting factors respectively decreased to about 40% and 30% to original in M1 and M2. The R value of TEG prolonged to (6.32±0.85) min and (7.27±0.63) min respectively, still within the normal range(baseline 4.97±1.04). The fibrinogen concentration in the M1 and M2 model decreased to (1.10±0.08) g/L and (0.81±0.10) g/L(P<0.01), which had the same variation tendency to Alpha angle of TEG (25.65±4.95 vs 16.63±3.94, P>0.05). 【Conclusion】 MTP with blood components supplemented such as platelet and cryoprecipitate in time has effectively improved the Plt and Fib in vitro large-dose blood loss/transfusion model.