Shifts of Transfusion Demand in Cardiac Surgery After Implementation of Rotational Thromboelastometry-Guided Transfusion Protocols
| Autor: | Jos G. Maessen, Marcus D. Lancé, Wolfgang Buhre, Yvonne M. C. Henskens, Lieve T. van Egmond, Paul Roekaerts, Hugo ten Cate, Gerhardus J.A.J.M. Kuiper |
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| Přispěvatelé: | MUMC+: DA CDL Algemeen (9), RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, Faculteit FHML Centraal, MUMC+: MA Intensive Care (3), RS: Carim - V04 Surgical intervention, MUMC+: MA Medische Staf IC (9), MUMC+: MA Off Man Secr IC (9), MUMC+: MA Arts Assistenten IC (9), Intensive Care, RS: CARIM - R2.12 - Surgical intervention, MUMC+: MA Cardiothoracale Chirurgie (3), CTC, Interne Geneeskunde, MUMC+: MA Alg Interne Geneeskunde (9), MUMC+: HVC Pieken Trombose (9), RS: Carim - B04 Clinical thrombosis and Haemostasis, MUMC+: HVC Trombosezorg (8), Anesthesiologie, MUMC+: MA Anesthesiologie (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
PREDICTION Blood Loss Surgical computer.software_genre law.invention Randomized controlled trial law Medicine Prospective Studies Registries Netherlands RISK Database CARDIOPULMONARY BYPASS ASSOCIATION Middle Aged REEXPLORATION Cardiac surgery Thrombelastography Survival Rate Thromboelastometry Cohort Female Cardiology and Cardiovascular Medicine Algorithms cardiac surgery medicine.medical_specialty Blood management CELL TRANSFUSION thromboelastometry Postoperative Hemorrhage MANAGEMENT Humans Blood Transfusion Cardiac Surgical Procedures Propensity Score Aged transfusion Hemostasis algorithm business.industry bleeding mortality Anesthesiology and Pain Medicine Propensity score matching Observational study business computer Follow-Up Studies |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia, 33(2), 307-317. W B Saunders Co-Elsevier Inc |
| ISSN: | 1053-0770 |
| Popis: | Objectives: Rotational thromboelastometry (ROTEM)-guided transfusion algorithms in cardiac surgery have been proven to be successful in reducing blood loss in randomized controlled trials. Using an institutional hemostasis registry of patients in cardiac surgery (HEROES-CS), the authors hypothesized that the use of ROTEM-guided transfusion algorithms would save blood products and overall costs in cardiac surgery in every day practice.Design: Observational, prospective open cohort database.Setting: Single-center academic hospital.Participants: Cardiac surgery patients.Interventions: Implementation of ROTEM-guided bleeding management.Measurements and Main Results: A classical-guided algorithm and a ROTEM-guided algorithm were used for patient blood management in 2 cohorts. Primary outcome was the use and amount of blood products and hemostatic medication. Secondary outcomes were amount of rethoracotomies, length of stay, and 30-day mortality. Finally, costs and savings were calculated. The classical -guided cohort comprised 204 patients, and ROTEM-guided cohort comprised 151 patients. Baseline characteristics showed excellent similarities after propensity score matching of 202 patients. Blood loss was lower after ROTEM guidance (p Conclusions: Implementation of a ROTEM-guided transfusion algorithm in cardiac surgery patients reduced the use of blood products and hemostatic medication, hereby saving costs. Reductions in mortality and rethoracotomy rates could not be found. (C) 2018 The Authors. Published by Elsevier Inc. |
| Databáze: | OpenAIRE |
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