In:
Clinical and Applied Thrombosis/Hemostasis, SAGE Publications, Vol. 22, No. 7 ( 2016-10), p. 648-655
Abstract:
Fibrinogen and fibrin formation have a key role in perioperative hemostasis. The aim of this study is to examine the association of postoperative hemostasis with a combined evaluation of the fibrinogen level and fibrin polymerization in cardiac surgery. We retrospectively classified 215 consecutive cardiac surgery patients into 4 groups (Fuji-san classification) that were divided by fibrinogen level 〈 150 mg/dL (ie, hypofibrinogenemia) and fibrinogen thromboelastometry value at 10 minutes with rotational thromboelastometry 〈 6 mm (ie, low fibrin polymerization) at the warming of cardiopulmonary bypass. Four groups resulted; group I, the acceptable range (n = 85); group II, only hypofibrinogenemia ( 〈 150 mg/dL, ≥6 mm, n = 63); group III, hypofibrinogenemia and low fibrin polymerization ( 〈 150 mg/dL, 〈 6 mm, n = 60); and group IV, only low fibrin polymerization (≥150 mg/dL, 〈 6 mm, n = 7). The risk of chest tube drainage volume greater than 500 mL within the first 24 hours after surgery (with group I as the reference) was increased in group II (odds ratio [OR], 3.3; 95% confidence interval [CI] , 1.5-7.4; P 〈 .01) and group III (OR, 8.5; 95% CI, 3.5-21.7; P 〈 .01), and the risk greater than 1000 mL (with group I as the reference) was increased in group III (OR, 4.0; 95% CI, 1.1-17.3; P = .03) and group IV (OR, 23.1; 95% CI, 3.2-201.0; P 〈 .01). Intraoperative blood transfusions were decreased by 24.5%, after stratifying the starting amount of fresh frozen plasma by the 4-group classification in the recent consecutive 65 (30.2%) patients ( P 〈 .01). The 4-group classification is associated with postoperative bleeding and may improve the quality of perioperative blood transfusion in cardiac surgery.
Type of Medium:
Online Resource
ISSN:
1076-0296
,
1938-2723
DOI:
10.1177/1076029615597061
Language:
English
Publisher:
SAGE Publications
Publication Date:
2016
detail.hit.zdb_id:
2230591-9
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