Low Preoperative Fibrinogen Plasma Concentration Is Associated With Excessive Bleeding After Cardiac Operations

Waldén, Katarina; Jeppsson, Anders; Nasic, Salmir; Backlund, Erika; Karlsson, MariAnne

doi:10.1016/j.athoracsur.2013.11.064

Cited by 74 publications

(71 citation statements)

References 21 publications

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“…Hemostasis depends on binding of fibrinogen between activated platelets, subsequent cleavage of fibrinogen to fibrin, and fibrin polymerization to form a stable clot [3,4]. While low fibrinogen levels have been associated with increased surgery-and traumarelated bleeding [5][6][7][8][9], persistently high fibrinogen levels are associated with an increased risk of acute coronary syndrome and ischemic stroke [10,11]. Targeting a fairly high FIBTEM maximum clot firmness (MCF) of 22 mm, first-line hemostatic therapy with fibrinogen reduced transfusion requirements after major thoracic and thoracoabdominal surgery as compared to placebo in an experimental clinical study setting [12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Prüller¹,

Münch

Preininger

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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We showed herein by measurements of citrated whole blood samples from surgical patients that CFF MA values were different from FIBTEM MCF values measured in the same sample. Awareness that these whole blood assays provide different clot amplitude results is mandatory, particularly if they are being considered as tools for guiding fibrinogen supplementation. Thromboembolic side effects caused by a potentially too high fibrinogen substitution must also kept in mind in this context.

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Section: Introductionmentioning

confidence: 99%

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Prüller¹,

Münch

Preininger

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Where there is clinically significant bleeding during and after surgery, clotting factor and fibrinogen deficiencies should be excluded by other assessment methods [17].…”

Section: Which Multiplate ® Parameters Are Most Useful In the Preopermentioning

confidence: 99%

Consensus recommendations for using the Multiplate^® for platelet function monitoring before cardiac surgery

Kong

Trimmings

Hutchinson

et al. 2014

Int J Lab Hematology

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Summary Patients requiring urgent cardiac surgery are usually already taking antiplatelet drugs including aspirin and a P2Y12 ADP receptor antagonist (e.g., clopidogrel, prasugrel or ticagrelor). This presents clinicians with the challenge of balancing the risk of thrombotic complications, if antiplatelet drugs are stopped before surgery, with the problems of excessive bleeding when surgery is performed in the absence of adequate platelet function. Preoperative platelet function monitoring is able to identify when patients have recovered platelet function. The Multiplate® (multiple electrode impedance platelet aggregometer) is a point of care device that enables monitoring of platelet function. The authors offer recommendations based on real‐world, collective experience in the use of platelet function monitoring. These cover the use of the Multiplate® analyser to predict the need for platelet transfusion in the perioperative period and the individualized waiting period after cessation of P2Y12 ADP receptor antagonists before cardiac surgery.

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“…A Swedish study reported on 2 000 CABG patients,34 with a re-exploration rate of 4.9% and, interestingly enough, 10.0% (similar to the Tabula viva chirurgi) drained more than 1 000 ml, measured over 12 hours. In the Tabula viva chirurgi, the measurement was done over 48 hours.…”

Section: Discussionmentioning

confidence: 92%

“…Both Cleveland Clinic34 and the Japan Adult Cardiovascular Surgery Database (JACVSD)35 consider renal failure as new dialysis. The prevalence of renal failure (new dialysis) in the JACVSD was 3.18%.…”

Section: Discussionmentioning

confidence: 99%

Tabula viva chirurgi: a living surgical document

Swart

Joubert

Berg

et al. 2016

CVJA

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SummaryAim:The purpose of this article is to present the results of a private cardiac surgical practice. This information could also serve as a hermeneutical text for new wisdom.Methods:A personal database of 1 750 consecutive patients who had had coronary artery bypass graft (CABG) surgery was statistically analysed. Mortality and major morbidity figures were compared with large registries. Risk factors for postoperative death were determined.Results:Over a period of 12 years, 1 344 (76.8%) males and 406 (23.2%) females were operated on. The observed mortality rate was 3.03% and the expected mortality rate (EuroSCORE) was 3.87%. After stepwise logistic regression, independent risk factors for death were urgency (intra-aortic balloon pump), renal impairment (chronic kidney disease, stage III), re-operation and an additional procedure. Apart from the 53 deaths, another 91 patients had major complications.Conclusion:Mortality and morbidity rates compared favourably with other international registries. Mortality was related to co-morbidities. This outcome contributes to a hermeneutical understanding focusing on new spiritual wisdom and meaning for the surgeon.

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Low Preoperative Fibrinogen Plasma Concentration Is Associated With Excessive Bleeding After Cardiac Operations

Cited by 74 publications

References 21 publications

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Consensus recommendations for using the Multiplate^® for platelet function monitoring before cardiac surgery

Tabula viva chirurgi: a living surgical document

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Low Preoperative Fibrinogen Plasma Concentration Is Associated With Excessive Bleeding After Cardiac Operations

Cited by 74 publications

References 21 publications

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

Consensus recommendations for using the Multiplate® for platelet function monitoring before cardiac surgery

Tabula viva chirurgi: a living surgical document

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Product

Resources

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Consensus recommendations for using the Multiplate^® for platelet function monitoring before cardiac surgery