[Coagulation profiles during cardiac surgery].

Area of Science:

• Cardiovascular Surgery
• Hemostasis and Thrombosis
• Clinical Pathology

Context:

• Cardiac surgery patients often experience hemostasis disorders in the postperfusion period.
• Accurate assessment of coagulation is crucial for managing bleeding risks and optimizing patient care.

Purpose:

• To evaluate the hemostatic status of patients after cardiac surgery.
• To assess the utility of thromboelastometry and impedance aggregometry in diagnosing coagulation abnormalities.

Summary:

• 66 patients undergoing cardiac surgery were analyzed using thromboelastometry (Rotem Gamma) and impedance aggregometry (CHRONO-LOG).
• Significant hemostatic deviations were found in 52 patients, categorized into groups experiencing residual heparin effects, protamine sulfate excess, or dilution coagulopathy.
• Specific tests like external (exTem) and internal (inTem) coagulation pathways, heparin (hepTem), platelet function (fibTem), and platelet aggregation were assessed.

Impact:

• Findings highlight the need for precise monitoring of coagulation parameters post-cardiac surgery.
• The study demonstrates that combined thromboelastometric and aggregometric analysis provides valuable data for tailored treatment strategies.
• Improved management of hemostasis disorders can potentially reduce postoperative bleeding and the need for reoperations (resternotomy).