Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery
Abstract Background Coagulopathy and following massive bleeding are complications of cardiovascular surgery, particularly occurring after procedures requiring prolonged cardiopulmonary bypass (CPB). Reliable and rapid tests for coagulopathy are desirable for guiding transfusion. Measuring multiple c...
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doaj-292e2e1071904a7c87af2cb78e8b9e3d2021-10-10T11:37:11ZengBMCThrombosis Journal1477-95602021-10-011911610.1186/s12959-021-00324-4Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgeryYoshie Kawahara0Kohei Ohtsuka1Kimine Tanaka2Mayumi Yamanaka3Hiroyuki Kamiya4Takayuki Kunisawa5Satoshi Fujii6Department of Medical Laboratory and Blood Center, Asahikawa Medical University HospitalDepartment of Medical Laboratory and Blood Center, Asahikawa Medical University HospitalDepartment of Medical Laboratory and Blood Center, Asahikawa Medical University HospitalDepartment of Medical Laboratory and Blood Center, Asahikawa Medical University HospitalDepartment of Cardiac Surgery, Asahikawa Medical UniversityDepartment of Anesthesiology, Asahikawa Medical UniversityDepartment of Medical Laboratory and Blood Center, Asahikawa Medical University HospitalAbstract Background Coagulopathy and following massive bleeding are complications of cardiovascular surgery, particularly occurring after procedures requiring prolonged cardiopulmonary bypass (CPB). Reliable and rapid tests for coagulopathy are desirable for guiding transfusion. Measuring multiple coagulation parameters may prove useful. The purpose of this study is to determine the laboratory parameters predicting massive bleeding. Methods In a prospectively collected cohort of 48 patients undergoing cardiovascular surgery, markers of coagulation and fibrinolysis were measured using automated analyzer and their correlations with bleeding volume were determined. Results Operation time was 318 (107–654) min. CPB time was 181 (58–501) min. Bleeding volume during surgery was 2269 (174–10,607) ml. Number of transfusion units during surgery were packed red blood cells 12 (0–30) units, fresh frozen plasma 12 (0–44) units, platelets 20 (0–60) units and intraoperative autologous blood collection 669 (0–4439) ml. Post-surgery activities of coagulation factors II (FII), FV, FVII, FVIII, FIX, FX, FXI and FXII were decreased. Values of fibrinogen, antithrombin, α2 plasmin inhibitor (α2PI) and FXIII were also decreased. Values of thrombin-antithrombin complex (TAT) were increased. Values of FII, FIX, FXI and α2PI before surgery were negatively correlated with bleeding volume (FII, r = − 0.506: FIX, r = − 0.504: FXI, r = − 0.580; α2PI, r = − 0.418). Level of FIX after surgery was negatively correlated with bleeding volume (r = − 0.445) and level of TAT after surgery was positively correlated with bleeding volume (r = 0.443). Conclusions These results suggest that several clinical and routine laboratory parameters of coagulation were individually associated with bleeding volume during cardiovascular surgery. Determining the patterns of coagulopathy may potentially help guide transfusion during cardiovascular surgery.https://doi.org/10.1186/s12959-021-00324-4Cardiovascular surgeryDiluted coagulopathyHemorrhageLaboratory tests |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yoshie Kawahara Kohei Ohtsuka Kimine Tanaka Mayumi Yamanaka Hiroyuki Kamiya Takayuki Kunisawa Satoshi Fujii |
spellingShingle |
Yoshie Kawahara Kohei Ohtsuka Kimine Tanaka Mayumi Yamanaka Hiroyuki Kamiya Takayuki Kunisawa Satoshi Fujii Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery Thrombosis Journal Cardiovascular surgery Diluted coagulopathy Hemorrhage Laboratory tests |
author_facet |
Yoshie Kawahara Kohei Ohtsuka Kimine Tanaka Mayumi Yamanaka Hiroyuki Kamiya Takayuki Kunisawa Satoshi Fujii |
author_sort |
Yoshie Kawahara |
title |
Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
title_short |
Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
title_full |
Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
title_fullStr |
Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
title_full_unstemmed |
Use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
title_sort |
use of laboratory testing for prediction of postoperative bleeding volume in cardiovascular surgery |
publisher |
BMC |
series |
Thrombosis Journal |
issn |
1477-9560 |
publishDate |
2021-10-01 |
description |
Abstract Background Coagulopathy and following massive bleeding are complications of cardiovascular surgery, particularly occurring after procedures requiring prolonged cardiopulmonary bypass (CPB). Reliable and rapid tests for coagulopathy are desirable for guiding transfusion. Measuring multiple coagulation parameters may prove useful. The purpose of this study is to determine the laboratory parameters predicting massive bleeding. Methods In a prospectively collected cohort of 48 patients undergoing cardiovascular surgery, markers of coagulation and fibrinolysis were measured using automated analyzer and their correlations with bleeding volume were determined. Results Operation time was 318 (107–654) min. CPB time was 181 (58–501) min. Bleeding volume during surgery was 2269 (174–10,607) ml. Number of transfusion units during surgery were packed red blood cells 12 (0–30) units, fresh frozen plasma 12 (0–44) units, platelets 20 (0–60) units and intraoperative autologous blood collection 669 (0–4439) ml. Post-surgery activities of coagulation factors II (FII), FV, FVII, FVIII, FIX, FX, FXI and FXII were decreased. Values of fibrinogen, antithrombin, α2 plasmin inhibitor (α2PI) and FXIII were also decreased. Values of thrombin-antithrombin complex (TAT) were increased. Values of FII, FIX, FXI and α2PI before surgery were negatively correlated with bleeding volume (FII, r = − 0.506: FIX, r = − 0.504: FXI, r = − 0.580; α2PI, r = − 0.418). Level of FIX after surgery was negatively correlated with bleeding volume (r = − 0.445) and level of TAT after surgery was positively correlated with bleeding volume (r = 0.443). Conclusions These results suggest that several clinical and routine laboratory parameters of coagulation were individually associated with bleeding volume during cardiovascular surgery. Determining the patterns of coagulopathy may potentially help guide transfusion during cardiovascular surgery. |
topic |
Cardiovascular surgery Diluted coagulopathy Hemorrhage Laboratory tests |
url |
https://doi.org/10.1186/s12959-021-00324-4 |
work_keys_str_mv |
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