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The Bleeding Post-op CT Patient: Coagulation Tests Versus Thromboelastography

  • Oksana VolodEmail author
  • Julie Wegner
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Bleeding is a common complication of cardiac surgery associated with the derangements of the hemostatic system related to cardiopulmonary bypass and the effects and consequences of the disease state. The cause of post-operative bleeding is often multifactorial and minimizing bleeding requires not only the correction of deficiencies, but also balancing of the different blood components that contribute to clot formation. The standard coagulation tests (SCTs) frequently used by clinicians to assess coagulation capacity do not reflect the complexity of the coagulation system and typically do not provide timely information, resulting in empirical management of bleeding. Point-of-care viscoelastic hemostasis assays (VHA) are tests that monitor the different phases from clot formation to clot lysis in whole blood and provide the clinician with more complete information about imbalances in the coagulation system. Coupled with transfusion algorithms, the information provided by VHAs allows clinicians to better identify coagulation defects and improve therapeutic decision-making.

Keywords

Thromboelastography Thromboelastometry Sonoclot Cardiac surgery Adults Blood transfusions Bleeding Coagulation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineCedars Sinai Medical CenterLos AngelesUSA
  2. 2.South University OnlineSavannahUSA

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