Fibrinogen concentration significantly decreases after on-pump versus off-pump coronary artery bypass surgery: a systematic point-of-care ROTEM analysis
| Autor: | Michel Van Dyck, Dominique Thiry, David Glineur, Marie-Thérèse Rennotte, Cécile Carlier, Luc-Marie Jacquet, David Kahn, Mona Momeni, Stéphane Eeckhoudt, Philippe Baele, Laurent de Kerchove, Amine Matta, Christine Watremez, Cedric Hermans, André Gregoire |
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| Přispěvatelé: | UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, UCL - (SLuc) Service de pathologies cardiovasculaires intensives, UCL - (SLuc) Service d'hématologie, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Point-of-Care Systems Coronary Artery Bypass Off-Pump Fibrinogen law.invention Postoperative Complications law Cardiopulmonary bypass medicine Coagulation testing Humans Prospective Studies Coronary Artery Bypass Prospective cohort study Off-pump coronary artery bypass Aged Aged 80 and over medicine.diagnostic_test business.industry Middle Aged Thromboelastography Surgery Anesthesiology and Pain Medicine Bypass surgery Anesthesia Female Fresh frozen plasma Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia, Vol. 27, no. 1, p. 5-11 (2013) |
| Popis: | OBJECTIVES: Studies have emphasized the importance of normal fibrinogen concentrations in surgical patients. The primary hypothesis of this study was that fibrinogen levels significantly decrease in on-pump coronary artery bypass graft (CABG) surgery versus off-pump coronary artery bypass graft (OPCAB) surgery. The second objective was to show that ROTEM (TEM International, GmbH, Munich, Germany) rapidly detects these abnormalities compared with standard tests. DESIGN: A prospective, nonrandomized study. SETTING: A university hospital. PARTICIPANTS: Forty-two and 62 patients in the CABG and OPCAB groups, respectively, undergoing first-time bypass surgery were included. INTERVENTIONS: CABG versus OPCAB surgery. MEASUREMENTS AND MAIN RESULTS: Routine coagulation tests and ROTEM values were measured before anesthesia (T0), after the first dose of heparin (T1), after protamine (T2), upon intensive care unit arrival (T3), and 4 hours postoperatively (T4). The outcome measures were followed until 4 hours postoperatively. Fibrinogen concentrations were significantly lower in the CABG versus the OPCAB group at T2 (170 ± 44 v 243 ± 73 mg/dL, p < 0.001) and T3 (179 ± 42 v 232 ± 68 mg/dL, p < 0.001). This was confirmed by significantly lower FIBTEM maximal clot firmness values at T2 (9 ± 4 v 14 ± 5 mm, p < 0.001) and T3 (9 ± 4 v 13 ± 6 mm, p < 0.001). In the CABG group, patients received significantly more transfusions of all blood products except fresh frozen plasma. CONCLUSIONS: Fibrinogen concentration significantly decreases after cardiopulmonary bypass. ROTEM helps in its fast detection. |
| Databáze: | OpenAIRE |
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