TY - JOUR
T1 - Change in Hemostatic Intervention After Implementation of Thromboelastometry
AU - Hvas, Anne-Mette
AU - Boas, Tue Wincentz
AU - Jensen, Malene
AU - Lindskov, Christian
AU - Folkersen, Lars
AU - Ravn, Hanne Berg
N1 - Copyright © 2011. Published by Elsevier Inc.
PY - 2012/4
Y1 - 2012/4
N2 - OBJECTIVE: To monitor the use of blood products and hemostatic intervention after implementation of thromboelastometry. DESIGN: Observational prospective study using a historic control. SETTING: Single-center university hospital. PARTICIPANTS: Patients undergoing cardiac surgery during 2008 (n = 811) were compared with similar patients in 2009 (n = 865). INTERVENTIONS: Thromboelastometry was implemented in December 2008. Changes in transfusion of blood products and changes in use of recombinant factor VIIa and fibrinogen were studied. MEASUREMENTS AND MAIN RESULTS: Use of blood products was not decreased significantly after implementation of thromboelastometry. However, in patients receiving blood products, the units of red blood cells were decreased significantly (p = 0.04). Regarding hemostatic reagents, the use of recombinant factor VIIa was decreased significantly (p = 0.04), and the use of fibrinogen increased significantly (p <0.001). Most blood products (>70%) were given to a minority of patients (∼10%) in 2008 and 2009. In 2009, thromboelastometry was performed in 146 patients (17%), and the use of blood products (p <0.0001), recombinant factor VIIa (p <0.001), and fibrinogen (p <0.001) was significantly higher compared with patients in whom thromboelastometry was not performed. CONCLUSIONS: After implementation of thromboelastometry, the use of recombinant factor VIIa was decreased significantly, whereas the use of blood products was not decreased significantly in patients undergoing cardiac surgery.
AB - OBJECTIVE: To monitor the use of blood products and hemostatic intervention after implementation of thromboelastometry. DESIGN: Observational prospective study using a historic control. SETTING: Single-center university hospital. PARTICIPANTS: Patients undergoing cardiac surgery during 2008 (n = 811) were compared with similar patients in 2009 (n = 865). INTERVENTIONS: Thromboelastometry was implemented in December 2008. Changes in transfusion of blood products and changes in use of recombinant factor VIIa and fibrinogen were studied. MEASUREMENTS AND MAIN RESULTS: Use of blood products was not decreased significantly after implementation of thromboelastometry. However, in patients receiving blood products, the units of red blood cells were decreased significantly (p = 0.04). Regarding hemostatic reagents, the use of recombinant factor VIIa was decreased significantly (p = 0.04), and the use of fibrinogen increased significantly (p <0.001). Most blood products (>70%) were given to a minority of patients (∼10%) in 2008 and 2009. In 2009, thromboelastometry was performed in 146 patients (17%), and the use of blood products (p <0.0001), recombinant factor VIIa (p <0.001), and fibrinogen (p <0.001) was significantly higher compared with patients in whom thromboelastometry was not performed. CONCLUSIONS: After implementation of thromboelastometry, the use of recombinant factor VIIa was decreased significantly, whereas the use of blood products was not decreased significantly in patients undergoing cardiac surgery.
U2 - 10.1053/j.jvca.2011.07.018
DO - 10.1053/j.jvca.2011.07.018
M3 - Journal article
C2 - 21924638
SN - 1053-0770
VL - 26
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 2
ER -