• Michael I Meesters, David Burtman, Peter M van de Ven, and Christa Boer.
• Department of Anaesthesiology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: m.meesters@vumc.nl.
• J. Cardiothorac. Vasc. Anesth. 2018 Feb 1; 32 (1): 141-150.

ObjectiveThe aim was to evaluate the predictive value of thromboelastometry for postoperative blood loss in adult cardiac surgery with cardiopulmonary bypass.DesignRetrospective cohort study and systematic review of the literature.SettingA tertiary university hospital.Participants202 patients undergoing elective cardiac surgery.InterventionsThromboelastometry was performed before cardiopulmonary bypass and 3 minutes after protamine administration.Measurements And Main ResultsThe cohort study showed that the preoperative and postoperative thromboelastometric positive predicting value was poor (0%-22%); however, the negative predicting value was high (89%-94%). The systematic review of the literature to evaluate the predictive value of thromboelastometry for major postoperative bleeding in cardiac surgery resulted in 1,311 articles, 11 of which were eligible (n = 1,765; PubMed and Embase, until June 2016). Two studies found a good predictive value, whereas the other 9 studies showed a poor predictability for major postoperative bleeding after cardiac surgery. The overall negative predicting value was high.ConclusionsThromboelastometry does not predict which patients are at risk for major postoperative bleeding.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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