Does a balanced colloid decrease perioperative blood loss in paediatric cardiac surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ariane Willems ◽  
Françoise De Groote ◽  
Denis Schmartz ◽  
Jean-François Fils ◽  
Philippe Van der Linden
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Perioperative Blood Loss ◽  
Paediatric Cardiac Surgery

Drugs to Minimize Perioperative Blood Loss in Cardiac Surgery

1997 ◽  
Vol 85 (6) ◽  
pp. 1258-1267 ◽  
Author(s):  
Andreas Laupacis ◽  
Dean Fergusson
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Perioperative Blood Loss

scholarly journals Drugs to Minimize Perioperative Blood Loss in Cardiac Surgery

1997 ◽  
Vol 85 (6) ◽  
pp. 1258-1267 ◽  
Author(s):  
Andreas Laupacis ◽  
Dean Fergusson
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Perioperative Blood Loss

Aprotinin does reduce blood loss and haemostatic activation in paediatric cardiac surgery

2001 ◽  
Vol 18 (Supplement 22) ◽  
pp. 31-32
Author(s):  
H. Mössinger ◽  
W. Dietrich ◽  
S. Braun ◽  
J. A. Richter
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Reduce Blood Loss ◽  
Paediatric Cardiac Surgery

Use of Thromboelastography to Assess Haemostatic Changes during Paediatric Cardiac Surgery and to Predict Post-Operative Bleeding.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1038-1038
Author(s):  
Beverley J. Hunt ◽  
S. Moganansundram ◽  
S. M. Tibby ◽  
F. Holton ◽  
A. Durward ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Circulatory Arrest ◽  
Characteristic Curve ◽  
Clot Formation ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Paediatric Cardiac Surgery ◽  
Functional Measure ◽  
Ethical Committee Approval

Abstract The management of post-operative bleeding in paediatric cardiac surgery is difficult because the underlying haemostatic changes have been poorly studied. The thromboelastogram (TEG) provides a real-time, functional measure of haemostasis, quantifying clot formation, strength and lysis. We investigated the use of serial intra-operative TEG to assess perioperative haemostatic changes and as an adjunct to demographic and laboratory variables for the prediction of bleeding following cardiopulmonary bypass (CPB) surgery. Ethical committee approval was obtained to study fifty-one children, median (interquartile) age 6.8 months (0.5 to 10.5) prospectively through CPB and for the first 24 hours after intensive care unit admission. Significant post-operative blood loss was defined as more than 10ml/kg in the first four post-operative hours. TEG readings and traditional coagulation parameters were measured throughout CPB. Forward stepwise logistic regression analysis was used to predict bleeding. The incidence of bleeding was 37% (19/51), with a mean 4-hour blood loss of 24 ml/kg. Both groups showed abnormalities in all TEG parameters (apart from lysis) at the end of CPB, which were more marked among those who bled (all p<0.05). Hyperfibrinolysis was not seen. Addition of heparinase to the TEG samples taken after protamine administration demonstrated a small but consistent heparin effect for all TEG parameters only among patients who bled, however this group exhibited comparable protamine:heparin ratios to those who did not (p = 0.22). Significant multivariate predictors of bleeding included fibrinogen level at induction of anaesthesia; occurrence of circulatory arrest; and two TEG parameters taken at the end of CPB: “k” (the time to maximal clot formation) and “angle” (the rate of clot formation). The final model predicted bleeding well, producing an area under the receiver operating characteristic curve of 0.855 (95% CI 0.750 to 0.960). In summary, the aetiology of bleeding after paediatric cardiac surgery appears to be due to inadequate clot formation rather than fibrinolysis. TEG readings taken at the end of CPB, in conjunction with laboratory and demographic variables may provide a useful predictor of post-operative bleeding.

scholarly journals SPECIFICITY OF USING TRANEXAMIC ACID IN PATIENTS WITH CARDIAC SURGERY

2021 ◽  
Vol 29 (5) ◽  
pp. 590-597
Author(s):  
K.V. Bodyakov ◽  
◽  
A.V. Marochkov ◽  
A.S. Kylik ◽  
V.A. Dudko ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Balance Method ◽  
Postoperative Blood Loss ◽  
Open Heart ◽  
Circulating Blood Volume ◽  
Perioperative Blood Loss

Objective. To evaluate the efficacy of tranexamic acid (TA) in cardiac surgery patients undergoing the open-heart surgery under conditions of artificial blood circulation (ABC) by determining the volume of perioperative blood loss using the hemoglobin balance method. Methods. A pilot non-randomized prospective clinical trial was conducted. To determine the effectiveness of TA use, 2 groups of patients were formed: the 1<sup>st</sup> group, without TA application (n=40), the 2<sup>nd</sup> group - with TA application intraoperatively (n=40). In group 2, prior to sternotomy, intravenous bolus injection of TA (1000 mg (20 ml of 5% solution)) was performed and further titration of TA through a syringe dispenser was continued at a rate of 4 ml/hour (200 mg/hour) until the end of the operation.The volume of intraoperative blood-loss was assessed by the hemoglobin balance method. A special protocol was developed to control the volume of postoperative blood loss. Results. The volume of circulating blood (VCB) calculated by Nadler’s formula for the first group was 5433.2 (5008.5; 5768.2) ml, for the second - 5214.0 (4944.1; 5546.8) ml. In the first group of patients who did not receive TA during open- heart surgery, the volume of blood loss was 1460.6 (1196.8; 1725.8) ml or 26.9 % of the average circulating blood volume (CBV), and in the second group of patients who received TA intraoperatively - 1090.7 (882.3; 1468.6) ml or 20.9% of the CBV (p<0,001). Conclusion. The application of TA in cardiac surgery patients during open-heart surgery with ABC according to the developed algorithm (1000 mg/bolus, titration during surgery-200 mg/h) for the purpose of blood saving the volume of blood-loss was reduced by 25.3% compared to the control group. What this paper adds Algorithm for the use of tranexamic acid to reduce perioperative blood loss in cardiac surgery using cardiopulmonary bypass (CPB) during open-heart surgery has been developed. This algorithm included intravenous tranexamic acid injection (1,000 mg.) followed by titration during the operation - 200 mg/h). The use of this algorithm in cardiac surgical procedures allows reducing the volume of blood loss by 25.3%.

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