9 0.8 RBC (×1012/L) 30 3.9 ± 0.6 27 4.1 ± 0.7 0.27 31 3.4 ± 0.5 27 3.5 ± 0.6 0.69 PLT (×109/L) 30 186.2 ± 52.9 28 181.1 ± 59.0 0.73 31 113.0 ± 45.1 27 116.6 ± 47.7 0.77 pH 16 7.38 ± 0.05 14 7.38 ± 0.04 0.66 25 7.41 ± 0.04 27 7.39 ± 0.06 0.048 Lactate (mmol/L) 16 2.8 ± 1.5 14 3.1 ± 2.4 0.68 25 2.6 ± 1.7 27 2.1 ± 1.4 0.18a BE (mmol/L) 16 (-3.9) ± 3.4 14 (-3.0) ± 3.5 0.48 25 (-2.7) ± 4.6 27 (-2.4) ± 2.5 0.75 Albumin (g/L) 28 38.3 ± 6.1 28 38.1 ± 7.3 0.92 31 33.2 ± 5.8 27 33.6 ± 4.5 0.79 Calcium (mmol/L) 25 2.1 ± 0.2 27 2.1 ± 0.2 0.91

31 2.0 ± 0.2 27 2.0 ± 0.2 0.28 INR 27 1.1 ± 0.2 28 1.1 ± 0.1 0.73 26 1.2 ± 0.2 24 1.2 ± 0.2 0.97 aPTT (s) 27 28.4 ± 6.4 28 25.7 ± 4.8 0.09 26 58.6 ± 36.6 24 39.2 ± 16.3 0.044a aMann-Whitney u test. The first TEG test in the goal-directed group showed R value of 10.1 ± 4.7 min, α angle of 44.1 ± 16.1, and MA value of 50.0 ± 12.1. Danusertib ic50 A follow-up TEG test between 24–48 hours after the first TEG test was available from 21 patients, with improved R value of 8.5 ± 4.7 min (p = 0.037), α angle

of 51.1 ± 11.5 (p < 0.001), and MA value of 52.0 ± 13.3 (p = 0.11). Clinical outcomes There were 3 deaths (1 for exsanguination at 24 h, 1 for multiple organ dysfunction at 72 h, 1 for coagulopathy at 14d) in the goal-directed group and 2 deaths for coagulopathy (1 at 48 h and 1 at 72 h) in the control group. No significant differences were found in mortality at 28d, length of stay in ICU

and hospital between the two groups. Discussion This Metabolism inhibitor cohort study showed that goal-directed transfusion protocol via TEG was applicable in patients with abdominal trauma, and was associated with a trend towards fewer blood product utilization and better coagulation profile at 24 h compared to conventional Chloroambucil transfusion management. The results support the use of TEG in guiding transfusion management in patients with abdominal trauma. First, this study provides supplemental evidence for using TEG to guide transfusion management in the trauma setting. TEG has been shown to be helpful in ABT-737 in vitro detecting post-injury coagulopathy and directing transfusion management in patients with severe multiple trauma [13], but the use of TEG in patients with lower injury severity has not been thoroughly investigated, which may be due to the relatively low incidence of coagulopathy in moderately injured patients [2]. In this study, the majority of included patients sustained moderate abdominal injury, as suggested by mean ISS of 15.2 and mean abdominal AIS of 3.1.