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Bleeding and management of coagulopathy.

Publication ,  Other
Sniecinski, RM; Levy, JH
Published in: J Thorac Cardiovasc Surg
September 2011

Bleeding after cardiac surgery remains a significant problem, increasing both length of stay and mortality, and is caused by multiple factors including dilutional changes, ongoing fibrinolysis, and platelet dysfunction. The evaluation of coagulopathy is problematic because of the long turnaround time of standard coagulation tests. Algorithms involving point of care testing, including thromboelastography and thromboelastometry, have been published; all have the potential to reduce transfusion requirements. Massive transfusion coagulopathy that occurs in trauma can also be seen in complex aortic surgery and other massive bleeding patients and should prompt consideration of a transfusion protocol involving fixed ratios of fresh frozen plasma, platelets, and red blood cells. Pharmacologic agents such as antifibrinolytics are commonly administered, but a multimodal approach to management is important. Recombinant and purified coagulation products are being studied and provide clinicians specific agents to treat targeted deficiencies. A general multi-modal approach is required and recommendations are made for the management of bleeding and coagulopathy in cardiac surgical patients.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

September 2011

Volume

142

Issue

3

Start / End Page

662 / 667

Location

United States

Related Subject Headings

  • Tranexamic Acid
  • Thrombelastography
  • Respiratory System
  • Recombinant Proteins
  • Hemostatics
  • Fibrinogen
  • Deamino Arginine Vasopressin
  • Cardiac Surgical Procedures
  • Blood Volume
  • Blood Transfusion
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sniecinski, R. M., & Levy, J. H. (2011). Bleeding and management of coagulopathy. J Thorac Cardiovasc Surg. United States. https://doi.org/10.1016/j.jtcvs.2011.03.015
Sniecinski, Roman M., and Jerrold H. Levy. “Bleeding and management of coagulopathy.J Thorac Cardiovasc Surg, September 2011. https://doi.org/10.1016/j.jtcvs.2011.03.015.
Sniecinski RM, Levy JH. Bleeding and management of coagulopathy. Vol. 142, J Thorac Cardiovasc Surg. 2011. p. 662–7.
Sniecinski, Roman M., and Jerrold H. Levy. “Bleeding and management of coagulopathy.J Thorac Cardiovasc Surg, vol. 142, no. 3, Sept. 2011, pp. 662–67. Pubmed, doi:10.1016/j.jtcvs.2011.03.015.
Sniecinski RM, Levy JH. Bleeding and management of coagulopathy. J Thorac Cardiovasc Surg. 2011. p. 662–667.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

September 2011

Volume

142

Issue

3

Start / End Page

662 / 667

Location

United States

Related Subject Headings

  • Tranexamic Acid
  • Thrombelastography
  • Respiratory System
  • Recombinant Proteins
  • Hemostatics
  • Fibrinogen
  • Deamino Arginine Vasopressin
  • Cardiac Surgical Procedures
  • Blood Volume
  • Blood Transfusion