Comparison of Three Transfusion Strategies for Central Venous Catheterization in Cirrhotics: A Randomized Clinical Trial (POCKET)
Liver Cirrhosis
About this trial
This is an interventional treatment trial for Liver Cirrhosis focused on measuring Liver cirrhosis, Blood coagulation, Thromboelastography, Blood transfusion, Catheterization, central venous
Eligibility Criteria
Inclusion Criteria:
- Chronic liver failure (cirrhosis or chronic graft dysfunction) from any cause and medical indication of central venous line placement
Exclusion Criteria:
- Acute liver failure or
- Use of therapeutic doses of oral or parenteral anticoagulants (unfractionated heparin or low molecular weight heparin or oral anticoagulants) or
- Use of oral or parenteral platelet aggregation inhibitors or
- Patients with von Willebrand syndrome or
- Over-the-guidewire central venous catheter changing
- Patients previously included in this study protocol during the same hospital stay
Sites / Locations
- Hospital Israelita Albert Einstein
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Experimental
Experimental
Coagulogram-based protocol
Thromboelastometry-based protocol
Restrictive strategy
Arm based on standard coagulation tests protocol to guide blood transfusion before central venous catheterization. The possible components to be used include fresh frozen plasma, platelets (random or aphaeresis) and or cryoprecipitate.
Arm based on rotational thromboelastometry (ROTEM(R)) protocol to guide blood transfusion before central venous catheterization. The possible components to be used include fresh frozen plasma, platelets (random or aphaeresis) and or cryoprecipitate.
Arm based on a restrictive protocol strategy based on INR/PT and platelets count. The possible components to be used include fresh frozen plasma and/or platelets (random or aphaeresis).