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. 2024 Aug 2;25:520. doi: 10.1186/s13063-024-08332-1

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — SPIRIT figure, schedule of enrolment, interventions, and assessments. -t₁: > 24 h before surgery; t₁: pre-surgery; t₂: after anesthesia induction but before incision; t₃: 1 h after incision; t₄: during closure if total surgery time > 1.5 h; t₅: end of surgery; t₆: > 6 h after finishing surgery. Blood samples: hemoglobin, electrolytes (sodium/potassium), kidney function (urea/creatinine), albumin. Basic coagulation: INR, APTT, thrombocytes and fibrinogen. Additional coagulation: plasminogen activator inhibitor, D-dimer, global fibrinolysis, thrombin generation fVII, von-Willebrand Factor and anti-thrombin III and stored serum. Complications: cardiopulmonary or neurologic complication within the 3 months after the study period. ROTEM, rotational thromboelastometry