Basora M, Fita G, Panigua P, Litvan H, Fló A, Reverter JC. [Survey of perioperative hemostasis and transfusion management in cardiac surgery: how do anesthesiologists practice?].
REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2010;
57:3-10. [PMID:
20196517 DOI:
10.1016/s0034-9356(10)70156-0]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE
To determine practices related to control of perioperative hemostasis and transfusion in patients undergoing cardiac surgery in Spain, including the extent to which protocols are being used.
METHODS
A questionnaire was created to collect information from physicians in anesthesiology and postoperative recovery care between July 1 and September 20, 2007. The physicians were asked about practice in the 12 months prior to the survey.
RESULTS
Thirty-four hospitals responded. Seventy percent reported that they did not have protocols or guidelines for the control of hemostasis during cardiac surgery. Forty-four percent did not have information on the proportion of patients who received transfusions; 47% gave transfusions to 75% of patients. The standard preoperative tests were platelet counts, activated partial thromboplastin time, and prothrombin time. Acetylsalicylic acid and clopidogrel were suspended before surgery at 15 (44%) and 25 (73%) hospitals, respectively. In cases of resistance to heparin, additional doses of the drug were injected, in combination with plasma or antithrombin in 29% and 12% of the hospitals, respectively. In the intensive postoperative recovery care unit, only 1 hospital used thromboelastography. Only 1 other hospital used a platelet function analyzer.
CONCLUSIONS
Hemostasis, perioperative coagulation, and criteria for transfusion vary widely among the hospitals surveyed. Few guidelines are available and they are not often being followed. A high percentage of patients receive transfusions, although not all hospitals can cite a figure. New technology has not been widely applied.
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