2001
DOI: 10.1097/00000542-200105000-00014
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Abstract: Use of a coagulation test-based transfusion algorithm in cardiac surgery patients with abnormal bleeding after CPB reduced non-erythrocyte allogeneic transfusions in the operating room and ICU blood loss.

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Cited by 261 publications
(183 citation statements)
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“…Th e m ajorit y reported a potential decrease in transfusion requirements following POC diagnostics. In two studies, the authors exclusively focused on coagulo pathic patients [13,14], in wh om POC techniques resulted in signifi cantly reduced postoperative blood loss and benefi cial eff ects in terms of clinically relevant endpoints. Nuttall et al [14] randomized patients to a control group following individual anesthesiologist's transfusion practices or a pro tocol group using a transfusion algorithm guided by coagulation tests (prothrombin time, aPTT, platelet counts, thromboelastogram maximum amplitude, and fibrinogen concentration).…”
Section: Cardiovascular Surgerymentioning
confidence: 99%
See 1 more Smart Citation
“…Th e m ajorit y reported a potential decrease in transfusion requirements following POC diagnostics. In two studies, the authors exclusively focused on coagulo pathic patients [13,14], in wh om POC techniques resulted in signifi cantly reduced postoperative blood loss and benefi cial eff ects in terms of clinically relevant endpoints. Nuttall et al [14] randomized patients to a control group following individual anesthesiologist's transfusion practices or a pro tocol group using a transfusion algorithm guided by coagulation tests (prothrombin time, aPTT, platelet counts, thromboelastogram maximum amplitude, and fibrinogen concentration).…”
Section: Cardiovascular Surgerymentioning
confidence: 99%
“…In two studies, the authors exclusively focused on coagulo pathic patients [13,14], in wh om POC techniques resulted in signifi cantly reduced postoperative blood loss and benefi cial eff ects in terms of clinically relevant endpoints. Nuttall et al [14] randomized patients to a control group following individual anesthesiologist's transfusion practices or a pro tocol group using a transfusion algorithm guided by coagulation tests (prothrombin time, aPTT, platelet counts, thromboelastogram maximum amplitude, and fibrinogen concentration). We recently published the results of a prospective study including coagulopathic patients in whom diff use bleeding was diagnosed after he parin reversal or increased blood loss was observed during the fi rst 24 hours postoperatively; the previous protocol group of Nuttall et al was now defi ned as our control group with conventional tests (platelet count, fi brinogen concentration, international normalized ratio [INR], aPTT, and activated clotting time [ACT]), and patients in the POC-guided group received repeated thromboelastometry and whole blood impedance aggregometry [13].…”
Section: Cardiovascular Surgerymentioning
confidence: 99%
“…Rapid hemostasis testing may be carried out in the clinical laboratory [3,4], in a satellite laboratory [5], or as point-of-care testing in the operating room or trauma suite [6][7][8][9][10][11].…”
Section: Clinical Situationmentioning
confidence: 99%
“…Several small, single‐center, randomized controlled trials (RCTs) in cardiac surgery have shown that when compared to conventional laboratory testing or clinician judgement alone, near‐patient testing reduced transfusion of RBC10, 11 or non‐RBC blood components 10, 11, 12, 13, 14, 15. In a multicenter RCT of more than 7400 patients, implementation of a blood management algorithm incorporating near‐patient tests, resulted in reduced RBC transfusion, platelet transfusion and overall bleeding 16.…”
Section: Introductionmentioning
confidence: 99%
“…This is an attractive clinical strategy since identification of patients at the highest risk of bleeding could potentially enable selective targeted treatments to prevent severe bleeding starting. Predictive near‐patient testing has been incorporated into several blood management algorithms evaluated in several previous RCTs, usually as a single step for selection of preventative treatments10, 12, 13, 15 or in combination with later diagnostic near‐patient testing in patients who develop bleeding despite preventative treatments 11…”
Section: Introductionmentioning
confidence: 99%