Evaluation of health outcomes after the implementation of rotational thromboelastometry in patients undergoing cardiac surgery.

Autor:	Rodríguez-Martín I; Clinical Biochemistry Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Sánchez-Mora C; Clinical Biochemistry Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Fernández-López AR; Anesthesia Service, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., González-Fernández FJ; Intensive Care Unit, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Téllez-Cantero JC; Cardiovascular Surgery Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Blanco-Marquez V; Anesthesia Service, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., García de la Borbolla M; Cardiovascular Surgery Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Santos-Jiménez JC; Cardiovascular Surgery Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., González-Rodríguez C; Clinical Biochemistry Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Garnacho-Montero J; Intensive Care Unit, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain., Sánchez-Margalet V; Clinical Biochemistry Department, Virgen Macarena University Hospital, University of Seville, Sevilla, Spain.
Jazyk:	angličtina
Zdroj:	Scandinavian journal of clinical and laboratory investigation [Scand J Clin Lab Invest] 2022 Apr; Vol. 82 (2), pp. 143-149. Date of Electronic Publication: 2022 Feb 03.
DOI:	10.1080/00365513.2022.2034038
Abstrakt:	Background: Viscoelastic tests (rotational thromboelastometry, ROTEM ® ), together with the implementation of a specific algorithm for coagulation management in cardiac surgery, enable perioperative coagulopathy to be better controlled. Methods: Retrospective cohort study including 675 patients who underwent cardiac surgery with cardiopulmonary bypass. The incidence of allogeneic blood transfusions and clinical postoperative complications were analyzed before and after ROTEM ® implementation. Results: Following viscoelastic testing and the implementation of a specific algorithm for coagulation management, the incidence of any allogeneic blood transfusion decreased (41.4% vs 31.9%, p  = .026) during the perioperative period. In the group monitored with ROTEM ® , decreased incidence of transfusion was observed for packed red blood cells (31.3% vs 19.8%, p  = .002), fresh frozen plasma (9.8% vs 3.8%, p  = .008), prothrombin complex concentrate administration (0.9% vs 0.3%, p  = .599) and activated recombinant factor VII (0.3% vs 0.0%, p  = .603). Increased incidence was observed for platelet transfusion (4.8% vs 6.8%, p  = .530) and fibrinogen concentrate (0.9% vs 3.5%, p  = .066), tranexamic acid (0.0% vs 0.6%, p  = .370) and protamine administration (0.6% vs 0.9%, p  = .908). Similar results were observed in the postoperative period, but with a decreased incidence of platelet transfusion (4.8% vs 3.8%, p  = .813). In addition, statistically significant reductions were detected in the incidence of postoperative bleeding (9.5% vs 5.3%, p  = .037), surgical reexploration (6.0% vs 2.9%, p  = .035), and length of Intensive Care Unit (ICU) stay (6.0 days vs 5.3 days, p  = .026). Conclusions: The monitoring of hemostasis by ROTEM ® in cardiac surgery, was associated with decreased incidence of allogeneic blood transfusion, clinical hematologic postoperative complications and lengths of ICU stay.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu