Document Detail


Reduced haemostatic factor transfusion using heparinase-modified thrombelastography during cardiopulmonary bypass.
MedLine Citation:
PMID:  11573637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We set out to determine if the heparinase-modified thrombelastogram using anticoagulated blood from patients during cardiac surgery could guide treatment with haemostatic components. In 60 patients a simple algorithm predicted a possible 60-80% decrease in the use of haemostatic components. In a second series, 30 patients were allocated to receive components using this intra-operative algorithm and 30 using clinical criteria and laboratory-based tests. Ten patients in the clinical group received a total of 16 units of fresh frozen plasma and nine platelet concentrates compared with five patients transfused with five units of fresh frozen plasma and one platelet concentrate in the algorithm group. Twelve-hour chest tube losses [algorithm group 470 (295-820) ml, clinically managed group 390 (240-820) ml (median, quartile values)] were not different between groups despite the threefold reduction in the use of haemostatic products, showing that intra-operative monitoring of coagulation in the anticoagulated patient can be used to guide treatment.
Authors:
D Royston; S von Kier
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  86     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-09-27     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  575-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Critical Care, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Harefield, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms
Blood Coagulation
Cardiopulmonary Bypass*
Heparin Lyase
Humans
Middle Aged
Monitoring, Intraoperative / methods*
Pilot Projects
Plasma*
Platelet Transfusion / methods*
Thrombelastography / methods*
Chemical
Reg. No./Substance:
EC 4.2.2.7/Heparin Lyase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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