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实施旋转血栓弹性描记术对心脏手术的影响:一项回顾性队列研究。

Effects of implementing rotational thromboelastometry in cardiac surgery: A retrospective cohort study.

机构信息

Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.

Department of Anesthesiology and Intensive Care, University of Turku, Turku, Finland.

出版信息

J Perioper Pract. 2021 Sep;31(9):326-333. doi: 10.1177/1750458920950662. Epub 2021 Jan 10.

Abstract

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.

摘要

自 2013 年以来,我院已开展旋转血栓弹性描记术以评估凝血功能障碍。本研究旨在回顾性评估血栓弹性描记术在心脏手术患者中的应用效果。共纳入 2012 年的 177 例患者和 2014 年的 177 例患者。2014 年,对 56 例患者进行了血栓弹性描记术检测。与 2012 年相比,2014 年患者的平均出血量减少,输血小板的患者数量减少,新鲜冰冻血浆的使用减少,而凝血酶原复合物浓缩物的使用增加。单独研究时,接受血栓弹性描记术检测的患者更常接受血小板、新鲜冰冻血浆、纤维蛋白原和凝血酶原复合物浓缩物治疗,但输血量较少。总之,实施血栓弹性描记术检测后,整体上血液制品的使用更为谨慎。使用血栓弹性描记术检测与增加凝血产品输注的可能性相关。然而,血栓弹性描记术检测似乎主要用于辅助管理大出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/171f/8406378/c35fb1669872/10.1177_1750458920950662-fig1.jpg

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