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Five-minute test to prevent postcardiotomy reexploration.

Shingo Kunioka1, Tomonori Shirasaka1, Masahiko Narita1

  • 1Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

JTCVS Techniques
|April 11, 2022
PubMed
Summary

The 5-minute test (FMT) effectively estimates pericardial bleeding after cardiac surgery, significantly reducing reexploration rates and total blood loss. This objective tool aids in preventing complications and improving patient outcomes in cardiovascular procedures.

Keywords:
CHF, chronic heart failureCPB, cardiopulmonary bypassFMT, 5-minute testICU, intensive care unitbleedingcardiac tamponadecomplicationperioperative carepostcardiotomy reexploration

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Area of Science:

  • Cardiovascular Surgery
  • Surgical Hemorrhage Management
  • Diagnostic Tools in Medicine

Background:

  • Postcardiotomy bleeding is a significant complication following cardiac surgery, often necessitating reexploration.
  • Accurate and timely assessment of pericardial bleeding is crucial for patient management.
  • Current methods for estimating bleeding may lack precision, leading to suboptimal clinical decisions.

Purpose of the Study:

  • To evaluate the efficacy of the 5-minute test (FMT) in quantifying pericardial bleeding in adult cardiac surgery patients.
  • To determine the correlation between FMT results and the actual amount of postcardiotomy bleeding.
  • To assess the impact of FMT implementation on postcardiotomy reexploration rates and postoperative bleeding volume.

Main Methods:

  • Retrospective analysis of 573 adult cardiac surgery patients (January 2016 - December 2019).
  • Patients divided into FMT group (n=278) and control group (n=295).
  • FMT involved measuring bleeding on gauze pads over 5 minutes; sternal closure threshold set at <100 g.

Main Results:

  • The FMT group showed a significantly lower reexploration rate (1.5% vs. 5.7%, P=.007).
  • Reduced postoperative bleeding volume was observed in the FMT group (median 1165 mL vs. 1440 mL, P=.005).
  • A significant positive correlation (r=0.322, P<.001) was found between FMT gauze weight and postcardiotomy bleeding.

Conclusions:

  • The 5-minute test (FMT) is an objective and effective tool for estimating postoperative bleeding in cardiac surgery.
  • Implementing FMT can help prevent postcardiotomy reexploration and decrease overall bleeding.
  • FMT aids in optimizing surgical decisions and improving patient safety after cardiovascular procedures.