Massive Intraoperative Blood Loss Secondary to Pulmonary Artery Injury During a Video-Assisted Thorascopic Surgery: The Importance of Protocols and Preparedness

Keyes, Brian J.; Giles, E.Jackson

doi:10.7759/cureus.1357

Cited by 1 publication

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“…As a minimal invasive operation, video-assisted thoracic surgery (VATS) has been more and more widely used for the diagnosis and management of pathologies in the thoracic cavity due to improved wound infection rates, decreased chance of wound dehiscence, and reduced recovery times compared with open thoracotomy (OT) ( 9 ). However, VATS may potentially results in significant perioperative blood loss due to the procedure's proximity to large vessels ( 10 , 11 ), that may potentially lead to postoperative anemia. Nevertheless, there is still not enough data on the possible predictors of anemia in patients after major surgeries.…”

Section: Introductionmentioning

confidence: 99%

Coagulation Status and Surgical Approach as Predictors of Postoperative Anemia in Patients Undergoing Thoracic Surgery: A Retrospective Study

Lang

Bao

2021

Front. Surg.

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Objective: Postoperative anemia is a common complication after a major surgery. Our study aims to identify factors that are associated with higher risk of developing postoperative anemia after thoracic surgery.Methods: We conducted a retrospective study of 465 patients who underwent pulmonary surgery in 2017 in Shanghai Pulmonary Hospital, China. Of them, 191 patients underwent standard open thoracotomy (OT), and 274 patients underwent video-assisted thoracic surgery (VATS). A total of 350 patients were diagnosed with postoperative anemia, and 115 patients did not have anemia. Multiple logistic regression was used to compute odds ratios for predicting preoperative anemia.Results: Postoperative anemia was associated with significantly lower weight (p < 0.001) and height (p = 0.022) of the patients, as well as higher prothrombin time (PT), and international normalized ratio (INR) (p = 0.012). Open thoracotomy resulted in a 1.2-fold increase in the incidence of postoperative anemia compared to VATS (p = 0.002). Multiple logistic regression analysis identified INR [OR (95% CI) 24.46 (2.05–292.27; p = 0.012] and surgical approach [OR (95% CI) 0.48 (0.31–0.74); p < 0.001] as predictors of postoperative anemia and postoperative drop in hemoglobin (Hb).Conclusion: Postoperative coagulation status and surgical approach are statistically significant predictors of postoperative anemia in patients undergoing thoracic surgery. International normalized ratio and surgical approach are specifically associated with Hb drop immediately after the surgery.

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Section: Introductionmentioning

confidence: 99%