Effects of hypothermia on thrombelastography in patients undergoing cardiopulmonary bypass |
| |
Authors: | Kettner S C; Kozek S A; Groetzner J P; Gonano C; Schellongowski A; Kucera M; Zimpfer M |
| |
Institution: | Department of Anaesthesiology and General Intensive Care, University of Vienna, Austria and Ludwig Boltzmann Institute of Clinical Anaesthesiology and Intensive Care, Vienna, Austria; Department of Computer Science, Technical University of Vienna, Treitlstr. 3/3/182, A-1040 Vienna, Austria |
| |
Abstract: | Thrombelastography (TEG) correlates with postoperative chest drain output
in patients undergoing cardiopulmonary bypass (CPB). In vitro incubation
with heparinase allows TEG monitoring during CPB, despite heparin
anticoagulation. Hypothermia impairs coagulation, but these effects cannot
be assessed by standard coagulation tests performed at 37 degrees C. The
aim of this study was to assess the effects of hypothermia on TEG.
Therefore, we have compared normothermic and temperature-adapted TEG in 30
patients undergoing CPB. Our data showed significantly impaired reaction
time (r), kinetic time (k), and angle alpha (alpha) in temperature-adapted
compared with normothermic TEG. Maximum amplitude (MA), reflecting absolute
clot strength, was not affected at temperatures of 33-37 degrees C. These
findings indicate a decrease in the speed of clot formation, but not
absolute deterioration in clot quality. Furthermore, heparinase-modified
TEG indicated that there were nine cases in which heparin effects persisted
after heparin reversal with protamine, providing a rational guide to
protamine therapy.
|
| |
Keywords: | |
本文献已被 Oxford 等数据库收录! |
|