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The Kaolin-Activated Thrombelastograph® Predicts Bleeding After Cardiac Surgery
- Source :
- Journal of Cardiothoracic and Vascular Anesthesia. 20:531-535
- Publication Year :
- 2006
- Publisher :
- Elsevier BV, 2006.
-
Abstract
- Objective: The objective of this study was to determine the relationship of the kaolin-activated Thrombelastograph® (TEG) with postoperative bleeding and laboratory tests of coagulation in the setting of cardiac surgery with the routine use of ϵ-aminocaproic acid. Design: Prospective observational study. Setting: An adult heart center at a tertiary referral, university hospital. Participants: Thirty adult cardiac surgical patients. Interventions: The kaolin-activated TEG, platelet counts, prothrombin times, activated partial thromboplastin times, and fibrinogen levels were measured before induction of anesthesia, during cardiopulmonary bypass, and on arrival in the intensive care unit. Mediastinal and thoracostomy drainage were measured every hour for 4 hours after arrival in the intensive care unit. Measurements and Main Results: Correlation and multivariate linear regression modeling were used to describe relationships among coagulation tests, TEG parameters, and early postoperative bleeding. The TEG maximum amplitude (MA) parameter correlated well with postoperative bleeding (r = −0.6, p = 0.0018), more so than platelet count (r = −0.45, p = 0.02), fibrinogen level (r = −0.40, p = 0.06), or prothrombin time (r = 0.43, p = 0.02). The receiver operating characteristic curve c-index describing MA as a predictor for postoperative bleeding is 0.78. Abnormalities in all the laboratory test results were associated with an abnormal MA. Conclusions: In conclusion, the kaolin-activated TEG is associated with early coagulopathic bleeding. It may reflect the severity of a global coagulopathy affecting both platelets and coagulation factors and be a guide to incremental prohemostatic therapy in this setting.
- Subjects :
- Male
medicine.medical_specialty
Point-of-Care Systems
Postoperative Hemorrhage
law.invention
law
medicine
Coagulopathy
Coagulation testing
Humans
Cardiac Surgical Procedures
Kaolin
Aged
Aminocaproates
Prothrombin time
Cardiopulmonary Bypass
medicine.diagnostic_test
Platelet Count
business.industry
Fibrinogen
medicine.disease
Intensive care unit
Thoracostomy
Antifibrinolytic Agents
Thromboelastography
Thrombelastography
Surgery
Cardiac surgery
Anesthesiology and Pain Medicine
Heparin Lyase
Anesthesia
Prothrombin Time
Female
Partial Thromboplastin Time
Cardiology and Cardiovascular Medicine
business
Partial thromboplastin time
Subjects
Details
- ISSN :
- 10530770
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiothoracic and Vascular Anesthesia
- Accession number :
- edsair.doi.dedup.....7149bf77f37073f73ac73589ea6d3098