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.

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Source
http://dx.doi.org/10.1053/j.jvca.2011.07.018DOI Listing

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