The previous study by Kashuk et al. [13] did not conclude the effect of MLN8237 purchase goal-directed transfusion management on mortality either, because of incomparable injury severity between the patient groups. Considering the potential of goal-directed transfusion protocol in decreasing transfusion-related morbidity and correcting post-injury coagulopathy, it would be justified to infer that

goal-directed transfusion protocol might improve mortality of trauma patients. Further studies are needed LY2874455 order to investigate this issue. Several limitations are worth considering when interpreting the results of this study. First, this is a retrospective study with small sample size. Due to the retrospective nature, we could not achieve two identical patient groups, as manifested by different admission systolic blood pressure between the two groups. Second, we did not abandon

conventional coagulation tests after implementation of TEG. Therefore, the influence of conventional coagulation testing results on goal-directed transfusion management could not be eliminated and should be taken into consideration. Third, we were using standard TEG to guide transfusion, rather than rapid TEG. Moreover, we were not able to perform “baseline TEG”, which was shown to be important for patients receiving TEG monitoring, since we were studying trauma patients in this study. Finally, this single institution experience Methamphetamine may not be generalized because of different strategies in resuscitation, transfusion,

and Transmembrane Transporters inhibitor operation between trauma centers. Conclusions In summary, the present study showed that goal-directed transfusion protocol via TEG was feasible in patients with abdominal trauma, and was better than conventional transfusion management in reducing blood product utilization and preventing coagulation function exacerbation. The results are in favor of implementation of goal-directed transfusion protocol in trauma patients. Further studies are needed to confirm the benefits of the novel transfusion strategy in the trauma setting. Authors’ information Jianyi Yin and Zhenguo Zhao are joint first authors. References 1. Sauaia A, Moore FA, Moore EE, Moser KS, Brennan R, Read RA, Pons PT: Epidemiology of trauma deaths: a reassessment. J Trauma 1995, 38:185–193.PubMedCrossRef 2. Brohi K, Singh J, Heron M, Coats T: Acute traumatic coagulopathy. J Trauma 2003, 54:1127–1130.PubMedCrossRef 3. MacLeod JB, Lynn M, McKenney MG, Cohn SM, Murtha M: Early coagulopathy predicts mortality in trauma. J Trauma 2003, 55:39–44.PubMedCrossRef 4. Maegele M, Lefering R, Yucel N, Tjardes T, Rixen D, Paffrath T, Simanski C, Neugebauer E, Bouillon B: Early coagulopathy in multiple injury: an analysis from the German Trauma Registry on 8724 patients. Injury 2007, 38:298–304.PubMedCrossRef 5.