Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Assessment of thrombin generation measured before and after cardiopulmonary bypass surgery and its association with postoperative bleeding

Coakley, Margaret, Hall, Judith Elizabeth, Evans, C., Duff, Elizabeth Mary, Billing, Valerie Christine, Yang, L., McPherson, Duncan Ian, Stephens, Elizabeth, Macartney, Nicola J., Wilkes, Antony Robert and Collins, Peter William 2011. Assessment of thrombin generation measured before and after cardiopulmonary bypass surgery and its association with postoperative bleeding. Journal of Thrombosis and Haemostatis 9 (2) , pp. 282-292. 10.1111/j.1538-7836.2010.04146.x

Full text not available from this repository.

Abstract

Background: Bleeding after cardiopulmonary bypass (CPB) is a major cause of morbidity and mortality and consumes large amounts of blood. Identifying patients at increased risk of bleeding secondary to hemostatic impairment may improve clinical outcomes by allowing early intervention. Methods: This present study recruited 77 patients undergoing CPB and measured coagulation screens, coagulation factors, TEG®, Rotem® and thrombin generation (TG) before surgery and 30 min after heparin reversal. The tests were analyzed to investigate whether they identified patients at increased risk of excess bleeding (defined as > 1000 mL) in the first 24 h postoperatively. Results: Patients who bled > 1000 mL had a lower: platelet count (P < 0.02), factors (F)IX, X and XI (P < 0.005), endogenous thrombin potential (ETP) and an initial rate of TG (P < 0.02) and higher activated partial thromboplastin time (aPTT) (P < 0.001) than patients who bled < 1000 mL. Receiver operating characteristic (ROC) analysis was significant for post-operative TG and aPTT (P < 0.001). Furthermore, reduced pre-operative TG was associated with increased postoperative bleeding (P < 0.02). Pre- and postoperative TG were correlated (q = 0.7, P < 0.001). TEG®, Rotem® and prothrombin time (PT) at either time point were not associated with increased bleeding. Conclusion: These data suggest that pre-operative defects in the propagation phase of hemostasis are exacerbated during CPB, contributing to bleeding post-CPB. TG taken both pre- and postoperatively could potentially be used to identify patients at an increased risk of bleeding post-CPB.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: cardiopulmonary bypass; hemorrhage; thrombin generation; thromboelastometry
Publisher: Wiley-Blackwell
ISSN: 1538-7933
Last Modified: 08 Mar 2019 22:55
URI: http://orca.cf.ac.uk/id/eprint/27407

Citation Data

Cited 60 times in Google Scholar. View in Google Scholar

Cited 40 times in Scopus. View in Scopus. Powered By Scopus® Data

Cited 23 times in Web of Science. View in Web of Science.

Actions (repository staff only)

Edit Item Edit Item