The use of Thromboelastometry and Tranexamic Acid Reduces Blood Loss and Transfusion Requirements in Cardiac Surgery under Cardiopulmonary Bypass
Ichikawa, J.; Kodaka, M.; Kitahara, T.; Sato, N.; Nishiyama, K.; Nakano, K.; Komori, M.
MASUI. Japanese Journal of Anesthesiology 64(2): 131-138
2015
ISSN/ISBN: 0021-4892 PMID: 26121803 Document Number: 681201
We evaluated whether using thromboelastometry and tranexamic acid influenced blood loss and transfusion requirements in cardiac surgery requiring cardiopulmonary bypass. We perfomed a retrospective analysis examining perioperative coagulation results, and the transfusion requirements of concentrated red cells (CRCs), fresh frozen plasma (FFP) and platelet administration between 12 months before and 10 months after thromboelastometry and tranexamic acid had been introduced in our institution. We also recorded patients' demographic details, the surgery performed and patient outcomes. After the introduction of thromboelastometry and tranexamic acid, fewer units of CRC were transfused during surgery, and fewer patients required postoperative CRC transfusion. Intra- and postoperative FFP requirements were also reduced. Intraoperative blood loss, blood loss in the first 24 hr after surgery, and length of hospital stay were also reduced. The use of ROTEM and tranexamic acid can potentially reduce blood loss and transfusion requirements in cardiac surgery.