PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

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

Abstract 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.
PMID
Related Publications

Validation of rotational thromboelastometry during cardiopulmonary bypass: A prospective, observational in-vivo study.

Correlations between global clotting function tests, duration of operation, and postoperative chest tube drainage in pediatric cardiac surgery.

Comparison of SEER Sonorheometry With Rotational Thromboelastometry and Laboratory Parameters in Cardiac Surgery.

Does rotational thromboelastometry (ROTEM) improve prediction of bleeding after cardiac surgery?

Activated coagulation time vs. intrinsically activated modified rotational thromboelastometry in assessment of hemostatic disturbances and blood loss after protamine administration in elective cardiac surgery: analysis from the clinical trial (NCT01281397).

Authors

Mayor MeshTerms

Blood Loss, Surgical

Cardiopulmonary Bypass

Chest Tubes

Preoperative Care

Thrombelastography

Keywords
Journal Title medicine
Publication Year Start




PMID- 28746233
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170807
LR  - 20170807
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Preoperative thromboelastometry for the prediction of increased chest tube output
      in cardiac surgery: A retrospective study.
PG  - e7669
LID - 10.1097/MD.0000000000007669 [doi]
AB  - 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.
FAU - Gozdzik, Waldemar
AU  - Gozdzik W
AD  - aDepartment of Anaesthesiology and Intensive Therapy bDepartment and Clinic of
      Cardiac Surgery, Wroclaw Medical University cCentre of Pain Therapy and
      Palliative Care, University Hospital, Wroclaw, Poland.
FAU - Adamik, Barbara
AU  - Adamik B
FAU - Wysoczanski, Grzegorz
AU  - Wysoczanski G
FAU - Gozdzik, Anna
AU  - Gozdzik A
FAU - Rachwalik, Maciej
AU  - Rachwalik M
FAU - Skalec, Tomasz
AU  - Skalec T
FAU - Kubler, Andrzej
AU  - Kubler A
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - *Blood Loss, Surgical
MH  - *Cardiopulmonary Bypass
MH  - *Chest Tubes
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Hemorrhage/*diagnosis
MH  - Postoperative Period
MH  - *Preoperative Care
MH  - Prognosis
MH  - Retrospective Studies
MH  - *Thrombelastography
EDAT- 2017/07/27 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007669 [doi]
AID - 00005792-201707280-00064 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7669. doi: 10.1097/MD.0000000000007669.