Prediction of Postoperative Blood Loss Using Thromboelastometry in Adult Cardiac Surgery: Cohort Study and Systematic Review

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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.

Original languageEnglish
Pages (from-to)141-150
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume32
DOIs
Publication statusPublished - Feb 2018

Cite this

@article{c704fb76e1724512b3b2103b2b395c36,
title = "Prediction of Postoperative Blood Loss Using Thromboelastometry in Adult Cardiac Surgery: Cohort Study and Systematic Review",
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.",
keywords = "Bleeding, Cardiac surgery, Prediction, Thromboelastometry, Transfusion",
author = "Meesters, {Michael I.} and David Burtman and {van de Ven}, {Peter M.} and Christa Boer",
year = "2018",
month = "2",
doi = "10.1053/j.jvca.2017.08.025",
language = "English",
volume = "32",
pages = "141--150",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
issn = "1053-0770",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Prediction of Postoperative Blood Loss Using Thromboelastometry in Adult Cardiac Surgery

T2 - Cohort Study and Systematic Review

AU - Meesters, Michael I.

AU - Burtman, David

AU - van de Ven, Peter M.

AU - Boer, Christa

PY - 2018/2

Y1 - 2018/2

N2 - 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.

AB - 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.

KW - Bleeding

KW - Cardiac surgery

KW - Prediction

KW - Thromboelastometry

KW - Transfusion

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U2 - 10.1053/j.jvca.2017.08.025

DO - 10.1053/j.jvca.2017.08.025

M3 - Article

VL - 32

SP - 141

EP - 150

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

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