Bleeding risk of dietary supplements: A hidden nightmare for cardiac surgeons

Abstract

We report a 55-year-old man who underwent off-pump bypass surgery and had diffuse oozing and bruising postoperatively. His hematological profile had been normal preoperatively and he had been off antiplatelets for a week prior to surgery. Postoperatively, a detailed talk revealed that he had been on dietary supplements containing fish oil and garlic - both of which are known to affect platelet function. It behooves the surgeon and anesthetist to screen all patients preoperatively for the possibility of intake of any dietary supplements taken by the patient.

Supervised machine learning models and protein-protein interaction network analysis of gene expression profiles induced by omega-3 polyunsaturated fatty acids

“…This information might support our ndings that PUFAs could potentially trigger the upregulation of complement/coagulation cascade genes, reconsidering current recommendations not to use sh oil before cardiac surgery [26]. The negative impact of some PUFA dietary components on sugar metabolism has been also examined in the study, where the authors evaluated them for the prevention and treatment of type 2 diabetes [26]. The evidence might suggest that consumption of sh oil supplements at high doses could lead to a further worsening of glucose metabolism [27].…”

“…Recently, the PUFA effect on preoperative bleeding has been estimated in the randomized placebo-controlled clinical trial to be associated with a lower risk of bleeding at higher sh oil levels [25]. This information might support our ndings that PUFAs could potentially trigger the upregulation of complement/coagulation cascade genes, reconsidering current recommendations not to use sh oil before cardiac surgery [26]. The negative impact of some PUFA dietary components on sugar metabolism has been also examined in the study, where the authors evaluated them for the prevention and treatment of type 2 diabetes [26].…”

Assessment of routine diet (garlic consumption) as a pre- and postoperative protocol in oral and maxillofacial surgical interventions: An evidence-based literature review

“…This may in turn prolong postoperative healing. It is pertinent to mention that despite being at an increased risk of PB, individuals consuming garlic present normal hematological profiles (Bedi et al, 2016). We therefore hypothesized that garlic consumption is a risk factor of PB during and after OMFS, and this warrants evaluation of patients' dietary habits (such as garlic consumption) prior to surgery.…”

Swedish registries are promising but of limited value without validation

“…Were they discontinued some days before the procedure if the patients were taken them? Were the patients on alternative medicines, which may or may not contribute to bleeding and needs more research [6,7]? Examples of possible concern are garlic, gingko, cranberry juice, vitamin E, ginseng, fish oil, and flaxseed oil.…”