Oh C-S, Choi J-W, Jung E, Kang W-S, Kim S-H
Department of Anaesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Korea.
Transfus Med. 2015 Feb;25(1):33-7. doi: 10.1111/tme.12175. Epub 2015 Feb 11.
The study was designed to evaluate the effect of warfarin on perioperative transfusion, bleeding and coagulation status in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
There were controversy about the effect of warfarin on perioperative transfusion and bleeding.
METHODS/MATERIALS: Medical records from 107 consecutive patients with atrial fibrillation (AF) on warfarin therapy undergoing cardiac surgery with cardiopulmonary bypass (CPB) from 2008 to 2013 at a single university teaching hospital were retrospectively reviewed to compare the patients on to those not on warfarin therapy in terms of perioperative transfusion requirement, postoperative 24-h bleeding amount, and coagulation status assessment using prothrombin time (PT), international normalised ratio (INR) and rotational thromboelastometry (ROTEM®).
Although PT/INR was significantly prolonged both before and after surgery in patients on warfarin therapy, ROTEM® data, perioperative transfusion requirement and postoperative 24-h bleeding amount (785 ± 331 vs 676 ± 303 mL, P = 0·089, respectively) were not significantly different between the patients on and those not on warfarin therapy.
In patients on warfarin therapy undergoing cardiac surgery with CPB, warfarin therapy did not significantly increase perioperative transfusion requirement and bleeding.
本研究旨在评估华法林对接受体外循环（CPB）心脏手术患者围手术期输血、出血及凝血状态的影响。
关于华法林对围手术期输血和出血的影响存在争议。
方法/材料：回顾性分析2008年至2013年在一所大学教学医院连续接受CPB心脏手术且正在接受华法林治疗的107例房颤（AF）患者的病历，比较使用华法林治疗的患者与未使用华法林治疗的患者在围手术期输血需求、术后24小时出血量以及使用凝血酶原时间（PT）、国际标准化比值（INR）和旋转血栓弹力图（ROTEM®）进行凝血状态评估方面的差异。
尽管接受华法林治疗的患者术前和术后PT/INR均显著延长，但在使用华法林治疗的患者与未使用华法林治疗的患者之间，ROTEM®数据、围手术期输血需求和术后24小时出血量（分别为785±331 vs 676±303 mL，P = 0·089）并无显著差异。
在接受CPB心脏手术且正在接受华法林治疗的患者中，华法林治疗并未显著增加围手术期输血需求和出血量。
Zotero 插件