Objectives: Rotational thromboelastometry (ROTEM)-guided transfusion algorithms in cardiac surgery have been proven to be successful in reducing blood loss in randomized controlled trials. Using an institutional hemostasis registry of patients in cardiac surgery (HEROES-CS), the authors hypothesized that the use of ROTEM-guided transfusion algorithms would save blood products and overall costs in cardiac surgery in every day practice.
Design: Observational, prospective open cohort database.
Setting: Single-center academic hospital.
Participants: Cardiac surgery patients.
Interventions: Implementation of ROTEM-guided bleeding management.
Measurements And Main Results: A classical-guided algorithm and a ROTEM-guided algorithm were used for patient blood management in 2 cohorts. Primary outcome was the use and amount of blood products and hemostatic medication. Secondary outcomes were amount of rethoracotomies, length of stay, and 30-day mortality. Finally, costs and savings were calculated. The classical-guided cohort comprised 204 patients, and ROTEM-guided cohort comprised 151 patients. Baseline characteristics showed excellent similarities after propensity score matching of 202 patients. Blood loss was lower after ROTEM guidance (p < 0.001). Absolute risk reduction was 17% for red blood cells (p = 0.024), 12% for fresh frozen plasma (p = 0.019), and 4% for thrombocyte concentrates (p = 0.582). More tranexamic acid was given, but not more fibrinogen concentrate, while desmopressin was given less often. Hospital length of stay was reduced by an overall median of 2 and a mean of 4 days (p < 0.001). Mortality and rethoracotomy rates were not affected. Potential savings were about €4,800 ($5,630) per patient.
Conclusions: Implementation of a ROTEM-guided transfusion algorithm in cardiac surgery patients reduced the use of blood products and hemostatic medication, hereby saving costs. Reductions in mortality and rethoracotomy rates could not be found.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/j.jvca.2018.08.203 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
SUMO-Specific Peptidase 5 Promotes Oesophageal Squamous Cell Carcinoma Growth through the NF-κB- Axis.
Front Biosci (Landmark Ed)
January 2025
Department of Cardiothoracic Surgery, The Affiliated Jiangyin Hospital of Nantong University, 214400 Jiangyin, Jiangsu, China.
Background: This study investigates the role of small ubiquitin-like modifier (SUMO)-specific peptidase 5 (SENP5), a key regulator of SUMOylation, in esophageal squamous cell carcinoma (ESCC), a lethal disease, and its underlying molecular mechanisms.
Methods: Differentially expressed genes between ESCC mouse oesophageal cancer tissues and normal tissues were analysed via RNA-seq; among them, SENP5 expression was upregulated, and this gene was selected for further analysis. Immunohistochemistry and western blotting were then used to validate the increased protein level of SENP5 in both mouse and human ESCC samples.
Prospective and Longitudinal Analysis of Lymphocyte Subpopulations in SARS-CoV-2 Positive and Negative Pneumonia: Potential Role of Decreased Naïve CD8 in COVID-19 Patients.
Viruses
December 2024
School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan.
: During the acute phase of COVID-19, a number of immunological abnormalities have been reported, but few studies longitudinally analyzed the specific subsets of peripheral blood lymphocytes. : In this observational, prospective, and longitudinal study, adult patients developing acute pneumonia during the COVID-19 pandemic have been followed up for 12 months. Peripheral blood lymphocyte subsets were assessed (with a specific focus on the memory markers) at 6 time points after the disease onset until 12 months.
View Article and Find Full Text PDFEffect of Mediterranean Diet in Combination with Isokinetic Exercise Therapy on Body Composition and Cytokine Profile in Patients with Metabolic Syndrome.
Nutrients
January 2025
Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada Unidad Morelos, Instituto Polítecnico Nacional, Boulevard de la Tecnología, 1036 Z-1, P 2/2, Atlacholoaya 62790, Morelos, Mexico.
Background: Metabolic syndrome (MS) is a combination of comorbidities that increase pro-inflammatory cytokines (PIC) production, with subsequent body composition (BC) abnormalities and high cardiovascular risk. Treatment with diet and exercise has been suggested as possible non-pharmacological adjuvant treatment.
Objective: To determine changes in BC and PIC in patients with MS after a Mediterranean-type diet (MedDiet) and/or isokinetic exercise (IE).
Dysregulation of Mitochondrial Homeostasis in Cardiovascular Diseases.
Pharmaceuticals (Basel)
January 2025
Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
Mitochondria dysfunction plays a central role in the development of vascular diseases as oxidative stress promotes alterations in mitochondrial morphology and function that contribute to disease progression. Redox imbalances can affect normal cellular processes including mitochondrial biogenesis, electrochemical equilibrium, and the regulation of mitochondrial DNA. In this review, we will discuss these imbalances and, in particular, the potential role of mitochondrial fusion, fission, biogenesis, and mitophagy in the context of vascular diseases and how the dysregulation of normal function might contribute to disease progression.
View Article and Find Full Text PDFPrediction Model for POstoperative atriaL fibrillAtion in caRdIac Surgery: The POLARIS Score.
J Clin Med
January 2025
Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy.
: New-onset postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, occurring approximately in one-third of the patients. This study considered all-comer patients who underwent cardiac surgery to build a predictive model for POAF. : A total of 3467 (Center 1) consecutive patients were used as a derivation cohort to build the model.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!