Morbidity of Bleeding After Cardiac Surgery: Is It Blood Transfusion, Reoperation for Bleeding, or Both?

Vivacqua, Alessandro; Koch, Colleen G.; Yousuf, Arshad M.; Nowicki, Edward R.; Houghtaling, Penny L.; Blackstone, Eugene H.; Sabik, Joseph F.

doi:10.1016/j.athoracsur.2011.03.105

Cited by 202 publications

(175 citation statements)

References 16 publications

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“…Because our sample was most frequently transfused with RBCs due to surgical technical reasons, patients would benefit from surveillance prevention bundles in the operating room. Process improvements to minimize blood use and requirements for re-exploration have been suggested in the literature (31) .…”

Section: Discussionmentioning

confidence: 99%

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Lopes

Brunori

Cavalcante

et al. 2015

Rev. esc. enferm. USP

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Objective: To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery. Method: A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. Results: The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3 /mm 3 , lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. Conclusion: Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

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Section: Discussionmentioning

confidence: 99%

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Lopes

Brunori

Cavalcante

et al. 2015

Rev. esc. enferm. USP

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“…Incydenty krwotoczne, jak również przetoczenia krwi podczas CABG są związane ze zwiększoną chorobowością i śmiertelnością [286,287]. Zidentyfikowano szereg czynników ryzyka krwawień związa-nych z CABG, obejmujących leczenie przeciwzakrzepowe, niedokrwistość przedoperacyjną, płeć żeńską, wiek, małą powierzchnię ciała, dysfunkcję nerek lub wątroby, pilne lub nagłe procedury, operacje rewizyjne i dziedziczoną lub nabytą dysfunkcję płytek krwi [288,289]. W punktach 5.6.6.1. i 5.6.6.2. szczegółowo omówiono kwestie związa-ne z czasem zaprzestania DAPT u pacjentów z NSTE-ACS poddawanych CABG.…”

Section: Krwawienie Związane Z Pomostowaniem Aortalno-wieńcowymunclassified

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Roffi¹,

Patrono²,

Collet³

et al. 2015

Kardiol Pol

210

165

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“…Perioperative hemostatic dysfunction may necessitate the transfusion of allogeneic blood products and is an independent risk factor for perioperative mortality [1,2]. Coagulopathies can be multifactorial in nature, a result of disturbances in physiology, dysfunctionalities of hemostatic factors, and abnormalities in blood plasma.…”

Section: Introductionmentioning

confidence: 99%

Perioperative coagulopathy monitoring

et al. 2013

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Coagulopathy is common in orthopedic surgery patients either due to acquired factors, such as surgery, trauma, medications, or hemorrhage. Perioperative monitoring of blood coagulation is critical to diagnose the causes of hemorrhage, guide hemostatic therapies, predict the risk of bleeding during surgical procedures, and reduce risk of postoperative cardiac and thromboembolic events. In contrast to previous interventions that measure specific portions of the clotting cascade (such as intrinsic or extrinsic pathways or platelet aggregation), ''Point-ofcare'' coagulation monitoring devices assess the viscoelastic properties of whole blood. These techniques have the potential to measure the entire clotting process, starting with fibrin formation, clot retraction, and fibrinolysis. Furthermore, the coagulation status of patients is assessed in whole blood, allowing the plasmatic coagulation system to interact with platelets and red cells, and thereby providing useful additional information on platelet function. Improved monitoring of coagulopathy is particularly important as new anticoagulant drugs emerge that affect the clotting cascade in novel ways, including the inhibition of intrinsic and extrinsic pathways and platelet function. It is important for orthopedic surgeons to understand the pharmacology and reversal of these drugs in the perioperative setting. The purpose of this review is to review the current techniques to monitoring perioperative coagulopathy and to identify the manner in which novel anticoagulant medications affect the clotting cascade with particular interest in trauma and spine surgery.

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Morbidity of Bleeding After Cardiac Surgery: Is It Blood Transfusion, Reoperation for Bleeding, or Both?

Cited by 202 publications

References 16 publications

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Perioperative coagulopathy monitoring

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