Can ROTEM Thromboelastometry Predict Postoperative Bleeding After Cardiac Surgery?

Objective: 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. Design: A prospective observational study. Setting: A single university hospital. Parti...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2008-10, Vol.22 (5), p.655-661
Main Authors: Davidson, Simon J., FIBMS, McGrowder, Donovan, PhD, Roughton, Michael, MSc, Kelleher, Andrea A., MD
Format: Article
Language:English
Subjects:
Aged
Anesthesia & Perioperative Care
Blood Coagulation
cardiac surgery
Cardiac Surgical Procedures - adverse effects
Critical Care
Female
Humans
Male
Middle Aged
postoperative bleeding
Postoperative Hemorrhage - diagnosis
Prospective Studies
ROTEM
Sensitivity and Specificity
Thrombelastography - instrumentation
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Summary:Objective: 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. Design: A prospective observational study. Setting: A single university hospital. Participants: Fifty-eight adult male and female patients undergoing primary coronary artery revascularization. Interventions: Blood samples taken preoperatively and at 1, 2, and 3 hours after surgery. Measurements and Main Results: Eight patients bled at least 200 mL/h in the study period. All (100%) had at least 1 abnormal ROTEM result in the study period. Of the 49 patients not found to be bleeding more than 200 mL/h in any of the first 4 postoperative hours, 46 (94%) had at least 1 abnormal ROTEM result. The positive and negative predictive values were 14.8% and 100%, respectively. Conclusions: 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.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2008.07.002