Incidence of Bleeding in Cardiac Surgery With Extracorporeal Circulation

Gilbert, Joseph W.; Bronson, William R.; Brecher, George

doi:10.1111/j.1749-6632.1964.tb41057.x

Cited by 11 publications

(2 citation statements)

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“…In prior studies, surgical causes of bleeding necessitating re-exploration were found to range from 35 to 100% [3][4][5][6][7][8][9][25][26][27][28][29]. Our study demonstrated that excessive post-operative bleeding is from surgical sources in the majority of patients (67%).…”

Section: Pre-operative and Operative Risk Characteristics Prediction Of Surgically Related Bleedingmentioning

confidence: 51%

“…Up to 12% of patients will r.equir~. reexploration following cardiac surgery which utilizes cardiopulmonary bypass [1][2][3][4][5][6][7][8][9][10][11][12]. Previous stud~es which have tried either to predict post-operatl,,:e hemorrhage or aid in defining the causes of th~s bleeding have had mixed results [13][14][15][16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Hemorrhage Related Reexploration following Open Heart Surgery: The Impact of Pre-Operative and Post-Operative Coagulation Testing

Hall

Sines

Spotnitz

2002

Cardiovascular Surgery

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Purpose: Our objective was to determine the association of pre-operative and post-operative coagulation testing abnormalities with the cause of post-operative bleeding requiring re-exploration following cardiac surgery. Methods: Retrospective chart review of post-operative bleeding and the incidence of re-exploration for hemorrhage in 2263 adult patients undergoing elective and emergency open heart surgery which included coronary artery bypass, valvular, and combined valve coronary procedures. Results: Eighty-two patients (3.6%) required re-exploration. Sixty-six percent had surgical bleeding; the remaining 34% were coagulopathic (no surgical site found). The pre-operative PT and ACT were significantly elevated in coagulopathic patients ( P<0.005). Post-operative ACT, PT, and APTT were increased and fibrinogen levels were decreased in coagulopathic patients ( P<0.05). Conclusions: Pre-operative testing (ACT, PT) weakly correlated with post-operative coagulopathy. Post-operative coagulation abnormalities were identified with high risk ratios and good diagnostic accuracy when using testing cut-off values to assist in surgical decision making.

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