Michael I Meesters1, David Burtman2, Peter M van de Ven3, Christa Boer2. 1. Department of Anaesthesiology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: m.meesters@vumc.nl. 2. Department of Anaesthesiology, VU University Medical Centre, Amsterdam, The Netherlands. 3. Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: The aim was to evaluate the predictive value of thromboelastometry for postoperative blood loss in adult cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective cohort study and systematic review of the literature. SETTING: A tertiary university hospital. PARTICIPANTS: 202 patients undergoing elective cardiac surgery. INTERVENTIONS: Thromboelastometry was performed before cardiopulmonary bypass and 3 minutes after protamine administration. MEASUREMENTS AND MAIN RESULTS: The cohort study showed that the preoperative and postoperative thromboelastometric positive predicting value was poor (0%-22%); however, the negative predicting value was high (89%-94%). The systematic review of the literature to evaluate the predictive value of thromboelastometry for major postoperative bleeding in cardiac surgery resulted in 1,311 articles, 11 of which were eligible (n = 1,765; PubMed and Embase, until June 2016). Two studies found a good predictive value, whereas the other 9 studies showed a poor predictability for major postoperative bleeding after cardiac surgery. The overall negative predicting value was high. CONCLUSIONS: Thromboelastometry does not predict which patients are at risk for major postoperative bleeding.
OBJECTIVE: The aim was to evaluate the predictive value of thromboelastometry for postoperative blood loss in adult cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective cohort study and systematic review of the literature. SETTING: A tertiary university hospital. PARTICIPANTS: 202 patients undergoing elective cardiac surgery. INTERVENTIONS: Thromboelastometry was performed before cardiopulmonary bypass and 3 minutes after protamine administration. MEASUREMENTS AND MAIN RESULTS: The cohort study showed that the preoperative and postoperative thromboelastometric positive predicting value was poor (0%-22%); however, the negative predicting value was high (89%-94%). The systematic review of the literature to evaluate the predictive value of thromboelastometry for major postoperative bleeding in cardiac surgery resulted in 1,311 articles, 11 of which were eligible (n = 1,765; PubMed and Embase, until June 2016). Two studies found a good predictive value, whereas the other 9 studies showed a poor predictability for major postoperative bleeding after cardiac surgery. The overall negative predicting value was high. CONCLUSIONS: Thromboelastometry does not predict which patients are at risk for major postoperative bleeding.
Authors: Werner Baulig; Samira Akbas; Michael Thomas Ganter; Oliver M Theusinger; Philipp K Schütt; Wolfgang Keul; Marija Jovic; Pascal Berdat; Stefanie von Felten; Klaus Steigmiller Journal: BMC Anesthesiol Date: 2021-10-28 Impact factor: 2.217