Bleeding risk assessment using whole blood impedance aggregometry and rotational thromboelastometry in patients following cardiac surgery.

Petricevic M, Biocina B, Milicic D, et al.
J Thromb Thrombolysis 2013;36:514-526.
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Review by : S. Kozek-Langenecker
NATA Review

The authors used perioperative point-of-care monitoring with thrombelastometry (TEG) and multiple electrode aggregometry (MEA) to predict postoperative bleeding in 148 patients undergoing cardiac surgery. The authors analyzed the changes in TEG and MEA before, during and after cardiopulmonary bypass (CPB). They also propose their own definition of excessive bleeding with a chest tube output over the 75th percentile (12.46 mL/kg in 24 h).

TEG and MEA results after protamine administration correlated with an excessive chest tube output in the first 24 h after surgery. Patients in the “bleeding” group were significantly more frequently on clopidogrel preoperatively. The authors encourage the use of both TEG and MEA, in order to be aware of an increased risk of bleeding in patients with altered results.

– Sibylle Kozek-Langenecker