PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 9919464

Factors that influence early extubation: bleeding.

T Ammar·G Silvay
View original source ↗Export metadata ↓

Abstract

Excessive bleeding after cardiac surgery is an important factor that can prevent early extubation. Hemostatic derangement is well recognized to be associated with cardiopulmonary bypass, with many possible contributing factors resulting in coagulation defects and fibrinolytic pathway activation. Measures to optimize hemostasis are critical when managing patients for whom early extubation and hospital discharge are goals. The intraoperative evaluation of the hemostatic system with tests like the thrombelastogram and the use of therapeutic agents such as aprotinin are simple, safe, and effective methods of achieving these goals.

Explore related subjects

AprotininBlood CoagulationCardiac Surgical ProceduresCardiopulmonary BypassFibrinolysisHemostasisHemostasis, SurgicalHemostatic TechniquesHemostaticsHumansIntubation, IntratrachealMonitoring, IntraoperativePatient DischargePostoperative HemorrhageThrombelastographyJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

T Ammar, G Silvay. 1998. Factors that influence early extubation: bleeding.. https://pubmed.ncbi.nlm.nih.gov/9919464/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Ultra-low dose aprotinin effects on reducing the need for blood transfusion in cardiac surgery.

OBJECTIVE: To assess the effects of ultra-low dose one million kallikrein inhibitor units (KIU) of aprotinin on bleeding and the need for transfusion after cardiac surgery. METHODS: We carried out this randomized clinical trial on 162 cardiac surgery patients in Shahid Madani Hospital, Tabriz, Iran from April 2004 to December 2005. The patients were randomly divided into 2 groups of 81 individuals. In the aprotinin group, 0.5 million KIU infused before and 0.5 million KIU during cardiopulmonary bypass. In the placebo group, 100 ml normal saline was infused as above. The need to use fresh frozen plasma (FFP), packed red blood cells (PRBCs) transfusion during, after operation, the rate of chest tubes drainage at 6, 12 and 24 hours after surgery were measured in 2 groups. RESULTS: Chest tubes drainage at 6 hours after surgery was 190 +/- 24 ml in the aprotinin group and 266 +/- 33 ml in the placebo group (p=0.066). The amount of bleeding at 12 and 24 hours was significantly different between 2 groups (p=0.048, p=0.009). The frequency of blood products transfusion in the aprotinin group was 68% and in the placebo group was 75% (p=0.02). The number of PRBCs and FFP units transfused were significantly lower in the aprotinin group (p=0.000, p=0.005). Total amount of blood and products transfusion in the aprotinin group was 2.56 +/- 0.27 units and in placebo group it was 4.37 +/- 0.27 units (p=0.0001). CONCLUSION: Results indicate that the use of one million KIU of aprotinin in cardiac surgery is effective in reducing postoperative bleeding and transfusion requirements.

Aprotinin↗
PubMed2006

Aprotinin; friend or foe? A review of recent medical literature.

Recent articles published in peer review journals have questioned the safety of using aprotinin in patients having heart surgery. Also, evidence has been published to suggest an increase in renal events in patients given aprotinin when compared to those where tranexamic acid was used. The present review will focus principally on the first of these articles in relation to previously published data and experience.

Aprotinin↗