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| 1 | Clinical Validation of Global Coagulation Tests to Guide Blood Component Transfusions in Cirrhosis and ACLF显示文摘Background and Aims:Patients with cirrhosis and acuteon-chronic liver failure(ACLF)may have bleeding complications and need for invasive procedures.Point-of-care(POC)coagulation tests like thromboelastography(TEG)and Sonoclot may be better for guiding patient management than the standard coagulation tests(SCTs),like prothrombin time,platelet count and international normalized ratio.Methods:We prospectively compared and validated the POC tests and SCTs in 70 persons with ACLF and 72 persons with decompensated cirrhosis who had clinical bleeding and checked for episodes of re-bleeding and transfusion requirements.We assessed pre-procedure requirement of blood components when correction was done based on an SCT or POC strategy.Results:Episodes of bleeding were seen in 45%and 28%of ACLF and cirrhosis patient,respectively(p=0.036),with the major site of bleeding being gastrointestinal(31%and 16%,respectively).Platelet counts correlated with TEG-maximum amplitude in cirrhosis(p=0.045)and prothrombin time correlated positively with TEG-reaction(R)time(p=0.032),TEG-Clot kinetics(K)time(p=0.042),Son-activated clotting time(p=0.038)and negatively with clot rate(p=0.043)in ACLF,making these correctable target variables in POC transfusion algorithms.Of 223 procedures,transfusion of fresh frozen plasma and platelet concentrate was reduced by 25%(p=0.035)and 20.8%(p=0.045)by using a POC strategy in 76 patients.Correction of deranged Son-activated clotting time and TEG-reaction time was noted in 68%and 72%after 24 h of fresh frozen plasma transfusion in ACLF and 85%and 80%in cirrhosis,respectively.Conclusions:Our study clinically validates that POC tests can better detect coagulation defects and transfusion thresholds in ACLF and cirrhosis,whereas use of conventional tests appear to be less suitable in patients with clinical bleeding.Trial Registration:NCT04332484. | Madhumita Premkumar Rohit Mehtani Smita Divyaveer Kamal Kajal Anand VKulkarni Syed Ahmed Harmanpreet Kaur Harpreet Kaur Radhakrishna Dhiman Ajay Duseja Arka De | 2021 | Journal of Clinical and Translational Hepatology2021，9，2： | 7 |
| 2 | The Ilizarov method in infected nonunion of fractures显示文摘 | Lalit Maini Manish Chadha Jashan Vishwanath Sudhir Kapoor Anil Mehtani B.K Dhaon | 2000 | Injury2000，，7： | 1 |
| 3 | Direct vasoactive effecls of the chro- mogranin A (CHGA) peptide eatestatin in humans in vivo显示文摘 | Fung MM Salem RM Mehtani P | 2010 | Clin Exp Hy- pertens2010，32，5： | 1 |
| 4 | Impact of Endoscopic Surveillance on Mortality From Barrett’s Esophagus–Associated Esophageal Adenocarcinomas显示文摘 | Douglas A. Corley Kunal Mehtani Charles Quesenberry Wei Zhao Jolanda de Boer Noel S. Weiss | 2013 | Gastroenterology2013，，： | 1 |
| 5 | Lsolated type Ⅲ A fracture of the coronoid process of ulna:a case report and brief review of litera-ture显示文摘 | Vishwanath J Agarwal A Mehtani A | 2002 | Arch OrthopTranma Surg2002，122，3： | 1 |
| 6 | Tuberculosis of upper dorsal spine causing respiratory distress due to tracheo-oeso- phageal compression: an unusual presentation显示文摘 | Mehtani A Jha A Kanojia RK | 2013 | J Indian Med Assoc2013，111，19： | 1 |
| 7 | Impact of endoscopic surveillance on mortality from Barrett's esophagusassociated esophageal adenocarcinomas显示文摘 | Corley D A Mehtani K Quesenberry C | 2013 | Gastroenterology2013，145，2： | 1 |
| 8 | Management of idiopath- ic clubfoot in toddlers by Ponseti's method显示文摘 | Verma A Mehtani A Sural S et a/ | 2012 | J Pediatr Or- thop B2012，21，1： | 1 |
| 9 | Direct vasoactive effects of the chromogranin A (CHGA) peptide catestatin in humans in vivo显示文摘 | Fung MM Salem RM Mehtani P etal | 2010 | Clin Exp Hypertens2010，32，5： | 1 |
| 10 | Management of idiopathic clubfoot in roddlers by Ponseti' s method 显示文摘 | Verma A Mehtani A Sural S | 2012 | J Pediatr Orthop B2012，，21： | 1 |
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