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Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study

Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perio...

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Autores principales: Gozdzik, Waldemar, Adamik, Barbara, Wysoczanski, Grzegorz, Gozdzik, Anna, Rachwalik, Maciej, Skalec, Tomasz, Kübler, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627859/
https://www.ncbi.nlm.nih.gov/pubmed/28746233
http://dx.doi.org/10.1097/MD.0000000000007669
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author Gozdzik, Waldemar
Adamik, Barbara
Wysoczanski, Grzegorz
Gozdzik, Anna
Rachwalik, Maciej
Skalec, Tomasz
Kübler, Andrzej
author_facet Gozdzik, Waldemar
Adamik, Barbara
Wysoczanski, Grzegorz
Gozdzik, Anna
Rachwalik, Maciej
Skalec, Tomasz
Kübler, Andrzej
author_sort Gozdzik, Waldemar
collection PubMed
description Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery. A total of 114 adult patients undergoing cardiac surgery with CPB were included in this retrospective analysis. Each patient had thromboelastometry tests done twice: preoperatively, before the induction of anesthesia and postoperatively, 10 minutes after heparin reversal with protamine after decannulation. Patients were placed into 1 of 2 groups depending on whether preoperative thromboelastometry parameters deviated from reference ranges: Group 1 [N = 29; extrinsically activated test (EXTEM) or INTEM results out of normal range] or Group 2 (N = 85; EXTEM and INTEM results within the normal range). We observed that the total amount of chest tube output was significantly greater in Group 1 than in Group 2 (700 mL vs 570 mL, P = .03). At the same time, the preoperative values of standard coagulation tests such as platelet count, aPTT, and INR did not indicate any abnormalities of coagulation. Preoperative coagulation abnormalities diagnosed with thromboelastometry can predict increased chest tube output in the early postoperative period in elective adult cardiac surgery. Monitoring of the coagulation system with thromboelastometry allows rapid diagnosis of coagulation abnormalities even before the start of the surgery. These abnormalities could not always be detected with routine coagulation tests.
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spelling pubmed-56278592017-10-12 Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study Gozdzik, Waldemar Adamik, Barbara Wysoczanski, Grzegorz Gozdzik, Anna Rachwalik, Maciej Skalec, Tomasz Kübler, Andrzej Medicine (Baltimore) 3300 Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery. A total of 114 adult patients undergoing cardiac surgery with CPB were included in this retrospective analysis. Each patient had thromboelastometry tests done twice: preoperatively, before the induction of anesthesia and postoperatively, 10 minutes after heparin reversal with protamine after decannulation. Patients were placed into 1 of 2 groups depending on whether preoperative thromboelastometry parameters deviated from reference ranges: Group 1 [N = 29; extrinsically activated test (EXTEM) or INTEM results out of normal range] or Group 2 (N = 85; EXTEM and INTEM results within the normal range). We observed that the total amount of chest tube output was significantly greater in Group 1 than in Group 2 (700 mL vs 570 mL, P = .03). At the same time, the preoperative values of standard coagulation tests such as platelet count, aPTT, and INR did not indicate any abnormalities of coagulation. Preoperative coagulation abnormalities diagnosed with thromboelastometry can predict increased chest tube output in the early postoperative period in elective adult cardiac surgery. Monitoring of the coagulation system with thromboelastometry allows rapid diagnosis of coagulation abnormalities even before the start of the surgery. These abnormalities could not always be detected with routine coagulation tests. Wolters Kluwer Health 2017-07-28 /pmc/articles/PMC5627859/ /pubmed/28746233 http://dx.doi.org/10.1097/MD.0000000000007669 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3300
Gozdzik, Waldemar
Adamik, Barbara
Wysoczanski, Grzegorz
Gozdzik, Anna
Rachwalik, Maciej
Skalec, Tomasz
Kübler, Andrzej
Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title_full Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title_fullStr Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title_full_unstemmed Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title_short Preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: A retrospective study
title_sort preoperative thromboelastometry for the prediction of increased chest tube output in cardiac surgery: a retrospective study
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627859/
https://www.ncbi.nlm.nih.gov/pubmed/28746233
http://dx.doi.org/10.1097/MD.0000000000007669
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