Factors associated with excessive postoperative blood loss and hemostatic transfusion requirements: A multivariate analysis in cardiac surgical patients

Anesthesia and Analgesia

Volumn 82, Issue 1, 1996, Pages 13-21

  Despotis, George J ^a   Filos, Kriton S ^a   Zoys, Timothy N ^a   Hogue Jr , Charles W ^a   Spitznagel, Edward ^b   Lappas, Demetrios G ^a  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b WASHINGTON UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; HEPARIN; PROTAMINE; WARFARIN;

ADULT; AGED; ARTICLE; BLOOD CLOTTING DISORDER; BLOOD CLOTTING TIME; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; CORE TEMPERATURE; EXTRACORPOREAL CIRCULATION; FEMALE; HEART SURGERY; HUMAN; MAJOR CLINICAL STUDY; MALE; PARTIAL THROMBOPLASTIN TIME; POSTOPERATIVE HEMORRHAGE; PRIORITY JOURNAL; PROTHROMBIN TIME; THROMBOCYTE COUNT; THROMBOCYTE DYSFUNCTION;

AGE FACTORS; AGED; ANIMALS; BLOOD COMPONENT TRANSFUSION; BLOOD LOSS, SURGICAL; CARDIOPULMONARY BYPASS; CHEST TUBES; DRAINAGE; FEMALE; HEMOSTASIS, SURGICAL; HEPARIN; HUMANS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PROSPECTIVE STUDIES; PROTAMINES; RISK FACTORS; SWINE; TIME FACTORS; WHOLE BLOOD COAGULATION TIME;

EID: 0030028375     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1097/00000539-199601000-00004     Document Type: Article

References (37)

1. Woodman RC, Harker LA. Bleeding complications associated with cardiopulmonary bypass. Blood 1990;76:1680-97.
2. Czer LS. Mediastmal bleeding after cardiac surgery: etiologies, diagnostic considerations, and blood conservation methods. J Cardiothorac Anesth 1989;3:760-75.
3. Boldt J, Schindler E, Osmer C, et al. Influence of different anticoagulation regimens on platelet function during cardiac surgery. Br J Anaesth 1994;73:639-44.
4. Gravlee GP, Haddon WS, Rothberger HK, et al. Heparin dosing and monitoring for cardiopulmonary bypass. A comparison of techniques with measurement of subclinical plasma coagulation. J Thorac Cardiovasc Surg 1990;99:518-27.
5. Jobes DR, Schaffer GW, Aitken GL. Increased accuracy and precision of heparin and protamine dosing reduces blood loss and transfusion in patients undergoing primary cardiac operations. J Thorac Cardiovasc Surg 1995;110:36-45.
6. Despotis GJ, Joist JH, Hogue CW, et al. The impact of heparin concentration and activated clotting time monitoring on blood conservation: a prospective, randomized evaluation in patients undergoing cardiac operations. J Thorac Cardiovasc Surg 1995;110:46-54.
7. Despotis GJ, Santoro SA, Spitznagel E, et al. Prospective evaluation and clinical utility of on-site monitoring of coagulation in patients undergoing cardiac operation. J Thorac Cardiovasc Surg 1994;107:271-9.
8. Holtquist R. Partial regression. In: Kotz S, Read CB, eds. Encyclopedia of statistical sciences. New York: John Wiley, 1985:616-8.
9. Petersen LR, Simonds RJ, Koistinen J. HIV transmission through blood, tissues, and organs. AIDS 1993;7(Suppl 1):S99-107.
10. Despotis GJ, Summerfield AL, Joist JH, et al. Comparison of activated coagulation time and whole blood heparin measurements with laboratory plasma anti-Xa heparin concentration in patients having cardiac operations. J Thorac Cardiovasc Surg 1994;108:1076-82.
11. Hill JD, Dontigny L, De Leval M, Mielke CH Jr. A simple method of heparin management during prolonged extracorporeal circulation. Ann Thorac Surg 1974;17:129-34.
12. Slaughter TF, LeBleu TH, Douglas JM Jr, et al. Characterization of prothrombin activation during cardiac surgery by hemostatic molecular markers. Anesthesiology 1994;80:520-6.
13. Jobes DR, Schwartz AJ, Ellison N, et al. Monitoring heparin anticoagulation and its neutralization. Ann Thorac Surg 1981;31:161-6.
14. Thomas DP, Barrowcliffe TW, Johnson EA, et al. The influence of tissue source, salt and molecular weight and heparin activity. Scand J Haematol Suppl 1980;36:40-9.
15. Weitz JI, Hudoba M, Massel D, et al. Clot-bound thrombin is protected from inhibition by heparin-antithrombin III but is susceptible to inactivation by antithrombin III-independent inhibitors. J Clin Invest 1990;86:385-91.
16. Khuri SF, Wolfe JA, Josa M, et al. Hematologic changes during and after cardiopulmonary bypass and their relationship to the bleeding time and nonsurgical blood loss. J Thorac Cardiovasc Surg 1992;104:94-107.
17. Hardy JF, Perrault J, Tremblay N, et al. The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases. Can J Anaesth 1991;38:511-7.
18. Blauhut B, Harringer W, Bettelheim P, et al. Comparison of the effects of aprotinin and tranexamic acid on blood loss and related variables after cardiopulmonary bypass. J Thorac Cardiovasc Surg 1994;108:1083-91.
19. Kestin AS, Valen R, Khuri SF, et al. The platelet function defect of cardiopulmonary bypass. Blood 1993;82:107-17.
20. Gravlee GP, Rogers AT, Dudas LM, et al. Heparin management protocol for cardiopulmonary bypass influences postoperative heparin rebound but not bleeding. Anesthesiology 1992;76:393-401.
21. Valeri CR, Khabbaz K, Khuri SF, et al. Effect of skin temperature on platelet function in patients undergoing extracorporeal bypass. J Thorac Cardiovasc Surg 1992;104:108-16.
22. Rohrer MJ, Natalae AM. Effect of hypothermia on the coagulation cascade. Crit Care Med 1992;1402-5.
23. Bashein G, Nessly ML, Rice AL, et al. Preoperative aspirin therapy and reoperation for bleeding after coronary artery bypass surgery. Arch Intern Med 1991;151:89-93.
24. Reich DL, Patel GC, Vela-Cantos F, et al. Aspirin does not increase homologous blood requirements in elective coronary bypass surgery. Anesth Analg 1994;79:4-8.
25. Dietrich W, Spannagl M, Schramm W, et al. The influence of preoperative anticoagulation on heparin response during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1991;102:505-14.
26. Tu JV, Jaglal SB, Naylor CD. Multicenter validation of a risk index for mortality, intensive care unit stay, and overall hospital length of stay after cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario. Circulation 1995;91:677-84.
27. Ferraris VA, Gildengorin V. Predictors of excessive blood use after coronary artery bypass grafting. A multivariate analysis. J Thorac Cardiovasc Surg 1989;98:492-7.
28. Goodnough LT, Verbrugge D, Vizmeg K, Riddell J IV. Identifying elective orthopedic surgical patients transfused with amounts of blood in excess of need: the transfusion trigger revisited. Transfusion 1992;32:648-53.
29. Balleisen L, Bailey J, Epping PH, et al. Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population. I. Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill-using, and menopause. Thromb Haemost 1985;54:475-9.
30. Meade TW, Chakrabarti R, Haines AP, et al. Characteristics affecting fibrinolytic activity and plasma fibrinogen concentrations. BMJ 1979;1:153-6.
31. Boisclair MD, Lane DA, Pnilippou H, et al. Mechanisms of thrombin generation during surgery and cardiopulmonary bypass. Blood 1993;82:3350-7.
32. Tabuchi N, de Haan J, Boonstra PW, van Oeveren W. Activation of fibrinolysis in the pericardial cavity during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1993;106:828-33.
33. Dorman BH, Spinale FG, Bailey MK, et al. Identification of patients at risk for excessive blood loss during coronary artery bypass surgery: thromboelastography versus coagulation screen. Anesth Analg 1993;76:694-700.
34. Gravlee GP, Arora S, Lavender SW, et al. Predictive value of blood clotting tests in cardiac surgical patients. Ann Thorac Surg 1994;58:216-21.
35. Essell JH, Martin TJ, Salinas J, et al. Comparison of thromboelastography to bleeding time and standard coagulation tests in patients after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1993;7:410-5.
36. Horst MH, Dlugos S, Path JJ, et al. Coagulopathy and intraoperative blood salvage (IBS). J Trauma 1992;32:646-53.
37. Moore EE, Dunn EL, Breslich DJ. Platelet abnormalities associated with massive autotransfusion. J Trauma 1980;20:1052-6.