• Alexander A Hanke, Ulf Herold, Daniel Dirkmann, Konstantinos Tsagakis, Heinz Jakob, and Klaus Görlinger.
• Department of Anesthesiology and Intensive Care Medicine, Hanover Medical School, Germany.
• Transfus Med Hemoth. 2012 Apr 1; 39 (2): 121-128.

BackgroundIn aortic surgery bleeding complications can be fatal. Therefore, rotational thromboelastometry(ROTEM™)-based coagulation management was introduced. MethodsAfter 5 cases of acute type A aortic dissection and aortic arch replacement had been treated based on ROTEM findings (ROTEM group; RG), 5 cases without ROTEM were matched as control group (CG). CG treatment was based on conventional tests and clinical findings. Blood component and coagulation factor requirements, ventilation time, duration of stay at intensive care unit (ICU), hospitalization, and thrombotic or bleeding incidents as well as transfusion-associated costs were compared. ResultsAdministration of blood products and coagulation factor concentrates, ventilation time, ICU length of stay, and hospitalization tended to be lower in RG. Postoperative plasma transfusion (p = 0.038), recognized incidents (p = 0.048), and resulting costs on coagulation treatment (p = 0.049) were significantly reduced. ConclusionOur data suggest that ROTEM-based coagulation management can reduce transfusion requirements and corresponding costs in patients with aortic arch replacement. These data has to be confirmed by prospective randomized trials.

11 keywords...

hide…