Rosenzweig Dow, Lamm Peter, Schmitz Christoph, Vogt Ferdinand
Department of Cardiac Surgery, Artemed Klinikum München Süd, 81379 Munich, Germany.
Department of Cardiac Surgery, University of Munich, 81377 Munich, Germany.
Medicina (Kaunas). 2025 Jan 27;61(2):230. doi: 10.3390/medicina61020230.
Operative blood loss is strongly correlated with morbidity and mortality in surgery. Various hemostatic agents are used to reduce bleeding in cardiothoracic procedures. We report our experience with a plant-based microporous polysaccharide hemostatic powder (Starsil Hemostat, Hemostat Medical GmbH, Velen, Germany). Data were collected retrospectively from 65 patients who underwent cardiac surgery at our institution from January 2012 to January 2015 with ( = 42) or without ( = 23; control group) the use of the hemostat powder. Primary endpoints were safety (e.g., laboratory parameters, adverse events, and infection parameters) and time to hemostasis when the hemostat powder was used. Other endpoints included operation time, hospitalization, quantity of the hemostat powder applied, and length of stay in the intensive care unit. The 65 patients (49 male:16 female) analyzed in the study underwent 65 cardiothoracic procedures, including off-pump coronary artery bypass grafts ( = 25), on-pump coronary artery bypass grafts ( = 6), valve procedures ( = 6), valve procedures in combination with bypass grafts ( = 7), and others ( = 21). The application of the hemostat powder did not increase adverse events. The laboratory parameters did not exceed the expected range after heart surgery in both groups. The hemostat powder had no significant impact on the laboratory parameters compared to the control group. Blood control was sufficient and was rated by surgeons from good to very good on a visual analog scale (VAS) from 1 (very bad) to 10 (very good) [VAS = 8.3 ± 1.2]. Intraoperative hemostasis was possible in nearly all patients. The hemostat powder led to satisfactory bleeding control within 2 min in 88% of cases. Five patients needed a second 5 g unit of the hemostat powder. The observed parameters between groups did not differ significantly. Therefore, the use of Starsil Hemostat in cardiothoracic surgery is safe and effective bleeding control was achieved.
手术失血与手术中的发病率和死亡率密切相关。在心胸外科手术中，人们使用各种止血剂来减少出血。我们报告了我们使用一种植物源微孔多糖止血粉（Starsil Hemostat，德国韦伦Hemostat Medical GmbH公司）的经验。回顾性收集了2012年1月至2015年1月在我院接受心脏手术的65例患者的数据，其中42例使用了止血粉，23例未使用（对照组）。主要终点是安全性（如实验室参数、不良事件和感染参数）以及使用止血粉时的止血时间。其他终点包括手术时间、住院情况、止血粉的使用量以及重症监护病房的住院时间。本研究分析的65例患者（49例男性，16例女性）接受了65例心胸外科手术，包括非体外循环冠状动脉搭桥术（25例）、体外循环冠状动脉搭桥术（6例）、瓣膜手术（6例）、瓣膜手术联合搭桥术（7例）以及其他手术（21例）。止血粉的应用并未增加不良事件。两组心脏手术后的实验室参数均未超出预期范围。与对照组相比，止血粉对实验室参数没有显著影响。血液控制充分，外科医生在1（非常差）至10（非常好）的视觉模拟量表（VAS）上给予的评分从良好到非常好[VAS = 8.3 ± 1.2]。几乎所有患者术中都能实现止血。88%的病例中，止血粉在2分钟内实现了令人满意的出血控制。5例患者需要额外使用5克单位的止血粉。两组之间观察到的参数没有显著差异。因此，在心胸外科手术中使用Starsil Hemostat是安全的，并且实现了有效的出血控制。
