Correlation of Thromboelastography Parameters with Bleeding Episodes of Post-LVAD Surgery
| Autor: | Pakpoom Tantrachoti, Wasawat Vutthikraivit, Nandini Nair, Pavida Pachariyanon, Benjamin A Hirsch |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty education.field_of_study medicine.diagnostic_test business.industry medicine.medical_treatment Population Retrospective cohort study Perioperative medicine.disease Thromboelastography Surgery Blood product Ventricular assist device Heart failure medicine Cardiology and Cardiovascular Medicine Adverse effect education business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 38:S193-S194 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2019.01.468 |
| Popis: | Purpose Left ventricular assist device (LVAD) is considered as an alternative treatment for patients with refractory end-stage heart failure. Perioperative bleeding is one of the most common adverse events of LVAD surgery. Thromboelastography (TEG; Haemoscope, Niles, IL, USA), a commercial assay that assesses clot formation, has been shown to reduce blood product use in cardiac surgeries. However, the information in LVAD surgery is very minimal. We aim to assess the statistical correlation between TEG parameters and bleeding during perioperative period. Methods We conducted a retrospective study of patients who underwent LVAD implantation at University Medical Center, Lubbock, Texas from July 1st, 2016 to July 31st, 2018. We excluded the patients whose TEG was not checked prior to LVAD surgery. We collected maximal amplitude of clot formation in response to arachidonic acid (MAAA), clot strength (GAA) and bleeding outcomes. Results Sixteen LVAD patients were included in the study with mean age of 57.2±8.2 years old (see table 1 for baseline characteristics and lab values). MAAA and GAA showed significant negative correlation with surgical drain output, number of packed red cell units and number of platelet units (p = 0.04, 0.04 and 0.01 respectively for MAAA and p = 0.04, 0.03 and 0.01 respectively for GAA). MAAA and GAA also showed moderate negative correlation with length of hospital stay and episodes of surgical re-exploration due to bleeding (r = -0.47 and -0.42 for MAAA and r = -0.43 and -0.42 for GAA) although without statistical significance (p ≥ 0.05). Conclusion Our study found that TEG parameters correlated significantly with drain output, number of packed red cell and platelet units used during perioperative period. They also tended to correlate with the hospital length of stay and surgical re-exploration but were likely limited by small number of study population. Further studies with larger population are needed for validation of the results. |
| Databáze: | OpenAIRE |
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