Role of Using a Thromboelastometry-Based Protocol for Transfusion Management in Combined Coronary Artery Bypass Grafting
- PDF / 419,010 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 2 Downloads / 202 Views
ORIGINAL ARTICLE
Role of Using a Thromboelastometry-Based Protocol for Transfusion Management in Combined Coronary Artery Bypass Grafting and Valve Surgery: A Randomized Clinical Trail Elham Khalaf-Adeli1 • Ali Akbar Pourfathollah1,2 • Fereidoon Noohi3 • Alireza Alizadeh-Ghavidel4 • Hooman Bakhshandeh-Abkenar5 • Roshanak Shamriz6 Seyed Mostafa Alavi5
•
Received: 23 October 2019 / Accepted: 26 October 2020 Ó Indian Society of Hematology and Blood Transfusion 2020
Abstract The aim of this study was to evaluate the impact of using a thromboelastometry-based protocol on transfusion requirements in patients undergoing combined coronary artery bypass grafting (CABG) and valve surgery. 80 adult patients scheduled for elective combined CABG and valve surgery were included in this clinical trial study. Patients were randomly allocated to the thromboelastometry (ROTEM) (n = 40) or control groups (n = 40). In the ROTEM group, transfusion was directed according to a thromboelastometry—based protocol. In the control group, transfusion was conducted according to the routine practices including conventional coagulation testing and clinical judgments. Finally, transfusion requirements were compared between groups. Use of thromboelastometrybased protocol resulted in 67% reduction in blood products units’ consumption as well as 23% in the percentage of & Seyed Mostafa Alavi [email protected] 1
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
2
Departments of Immunology, Faculty of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran
3
Cardiac Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
4
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, IranTehran, Iran
5
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Mellat park, Valiasr Avenue, Tehran, Iran
6
Coagulation Laboratory, Iranian Blood Transfusion Organization, Tehran, Iran
patients transfused. This reduction was especially evident in relation to fresh frozen plasma (FFP) and platelet consumption. No significant differences were found both in the percentage of patients receiving RBC and number of transfused RBC units. Using thromboelastometry tests incorporated a protocol results in reduction of transfusion requirements in patients undergoing elective combined CABG and valve surgery. Keywords Cardiovascular surgical procedures Thromboelastometry Blood transfusion Patient blood management
Introduction Acquired multifactorial coagulopathy in cardiac surgeries with cardiopulmonary bypass (CPB) increases risk of bleeding and transfusion requirements [1–5]. Use of blood products particularly plasma, is predominant in cardiovascular surgeries among various types of surgery. The mean of administered units per transfused patient is reported 4.0, 4.9, and 6.9, for Red blood cell (RBC), Fres
Data Loading...
