Hospital use of viscoelastic testing for guided management of massive haemorrhage: a unicenter quasi-experimental study

Abstract

Background: Massive haemorrhage is a condition in which bleeding occurs at a volume and rate that overwhelms the body's physiological compensatory mechanisms. It is a lethal circumstance leading to numerous preventable deaths. Viscoelastic tests have been incorporated into the management of patients with massive haemorrhage, due to their improvements over conventional coagulation tests. However, the effectiveness of reducing mortality rates remains uncertain due to contradicting research findings. Objectives: The main objective of this study is to evaluate whether the use of viscoelastic testing during hospital management of patients with massive hemorrhage is associated with reduced mortality at 24 hours compared to standard management using conventional testing. Desing and setting: This study is designed as a unicenter quasi experimental study. The study will compare two methods for treating massive haemorrhage: one guided by viscoelastic testing and the other guided by conventional coagulation testing. Participants and methods: We will select 290 participants to carry out the study. To be included they must have a massive haemorrhage, be over 18 years of age, must not receive anticoagulants or antiplatelet medications or have a known coagulopathy. An intervention group of 145 patients enrrolled using a consecutive samplig during 12 months will be set up to treat massive haemorrhage guided by viscoelastic testing . The control group of 145 patients enrolled retrospectively from hospital databases will consist of patients with massive haemorrhage who have received treatment guided by conventional coagulation testing.