Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Monitoring recombinant factor VIIa treatment: efficacy depends on high levels of fibrinogen in a model of severe dilutional coagulopathy.
Recombinant activated factor VII (rFVIIa) is increasingly being given to treat massive bleeding. However, there is no clear guidance on which patients are suitable for treatment and how the effects of treatment should be monitored. The aim of this in vitro study was to assess the coagulation status of severely hemodiluted blood samples before and after treatment with therapeutic doses of rFVIIa and/or fibrinogen with 2 viscoelastic point-of-care coagulation analyzers: ROTEM (Pentapharm GmbH, Munich, Germany) and Sonoclot (Sienco Inc, Arvada, CO). ⋯ ROTEM and Sonoclot were able to monitor the effects of rFVIIa and fibrinogen administration with 1:1,000 diluted tissue factor-activated tests. The efficacy of rFVIIa was largely dependent on the presence of high levels of fibrinogen in reversing this severe dilutional coagulopathy.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Can ROTEM thromboelastometry predict postoperative bleeding after cardiac surgery?
To evaluate the predictive ability of ROTEM thromboelastometry (Pentapharm, Basel, Switzerland) to identify patients bleeding more than 200 mL/h in the early postoperative period after cardiac surgery. ⋯ ROTEM thromboelastometry has poor predictive utility to identify patients who bleed more than 200 mL/h in the early postoperative period after cardiac surgery. However, its negative predictive value was good.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Acute Physiology and Chronic Health Evaluation (APACHE) III outcome prediction after major vascular surgery.
To investigate the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) III scoring system in patients admitted to the intensive care unit (ICU) after major vascular surgery. ⋯ The APACHE III scoring system discriminates well between survivors and nonsurvivors after major vascular surgery, but calibration of the model is poor.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Myocardial performance index is a predictor of outcome after abdominal aortic aneurysm repair.
Perioperative measurement of the myocardial performance index (MPI) with transesophageal echocardiography in patients undergoing elective abdominal aortic aneurysm repair and its association with outcome. ⋯ The MPI is an easily obtained echocardiographic measure of global ventricular performance, which can be measured perioperatively and may be useful as a prospective risk stratification index for patients undergoing elective abdominal aortic aneurysm surgery.