Thromboelastometry guided fibrinogen replacement therapy in cardiac surgery: a retrospective observational study

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• Managing bleeding after cardiac surgery is complex.
• Conventional methods may not always optimize hemostasis.
• Point-of-care testing offers potential for improved patient outcomes.

Purpose of the Study:

• To compare ROTEM-guided hemostasis with conventional management in cardiac surgery.
• To evaluate the impact on postoperative blood loss.
• To assess transfusion requirements and ICU length of stay.

Main Methods:

• Retrospective, observational study.
• Compared 40 patients managed with ROTEM to 40 control patients.
• ROTEM guided hemostatic management versus conventional bleeding management.

Main Results:

• ROTEM group received more fibrinogen (45% vs 10%) but fewer transfusions (40% vs 72.5%).
• Reduced postoperative bleeding (285 mL vs 393 mL) in the ROTEM group.
• Shorter ICU stay (43.7 h vs 52.5 h) for ROTEM-guided patients.

Conclusions:

• ROTEM-guided bleeding management is superior to conventional methods in complex cardiac surgery.
• It leads to decreased postoperative blood loss and transfusion needs.
• It also results in a shorter intensive care unit stay.