Anaesthesia, the journal of the Association of Anaesthetists of Great Britain & Ireland, announces the publication of a special open-access supplement on Transfusion, Thrombosis and Management of Bleeding, to coincide with the UK launch of Patient Blood Management in the NHS. A collaboration between anaesthetists, haematologists, surgeons and others, this supplement pulls together state-of-the-art research and […]
Over the last decade, viscoelastic tests have been increasingly used in different clinical conditions associated with a high bleeding risk. Both thromboelastography (TEG) and rotational thromboelastometry (ROTEM) have been used successfully to monitor coagulopathy and guide haemostatic therapies in bleeding patients. With the exception of trauma patients, these tests have been little studied in critically […]
Children undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at increased risk for postoperative bleeding and transfusion requirement. Perioperative management of neonates undergoing cardiac surgery is much more challenging because the CPB priming volume is usually as high as the circulating blood volume, the immaturity of the coagulation system increases the magnitude of perioperative coagulopathy, […]
The authors assessed bleeding events in patients with atrial fibrillation and receiving either dabigatran or warfarin. Data from a randomly selected cohort of only 5% of all patients registered for Medicare beneficiaries were analysed. This approach was suggested to represent postmarketing real-life clinical conditions. Consistent with the results of the RE-LY trial, intracranial haemorrhage was […]
Thromboelastometry-guided intraoperative haemostatic management reduces bleeding and red cell transfusion after paediatric cardiac surgery.
Over the past decade, viscoelastic tests have been increasingly used in different clinical settings. Although there is a growing literature showing advantages of implementing algorithm-based strategies to guide administration of haemostatic agents/products, only limited evidence exists in the paediatric cardiac population. In this study, Nakayama et al. performed a 2-step trial with the aim of […]
Thromboelastography is a suboptimal test for determination of the underlying cause of bleeding associated with cardiopulmonary bypass and may not predict a hypercoagulable state.
Welsh and colleagues investigated thrombelastography (TEG) and conventional coagulation tests (CCT) in 67 retrospectively studied cardiac surgery patients. They describe a very nice local coagulation-based haemotherapy (CBH) service run by the department of pathology. The CBH service provides intra- and postoperative assessment of coagulopathy and haemotherapy based on predefined algorithms. The collected patients were treated […]