Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/59072
Type: Artigo de Periódico
Title: Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery
Authors: Andre Soares Santos
Kenya Valeria Micaela de Souza Noronha
Monica Viegas Andrade
Abstract: The meta-analysis by Serraino and Murphy1 on viscoelastic haemostatic assays (VHA) for the diagnosis and treatment of coagulopathic bleeding in cardiac surgery and subsequent comments2,3 suggest some uncertainty around the association between transfusion of allogeneic red blood cells, fresh frozen plasma, and platelets and final outcomes, as discussed.1 Kozek and colleagues2 made two arguments using final outcomes to justify their support of VHA: (i) the observed risk reduction in acute renal failure reported by Serraino and Murphy1 (odds ratio [OR]=0.42, 95% confidence interval [CI]=0.20–0.86; P=0.02; four studies, 424 patients; data taken from supplementary materials provided by the authors) and (ii) the risk reduction in mortality reported by Wikkelsø and colleagues4,5 (3.9% vs 7.4%; relative risk [RR]=0.52, 95% CI=0.28–0.95; P=0.033, not specific for cardiac patients). We agree that the reduction of the risk of acute renal failure is an important outcome, but the mortality reduction reported by Wikkelsø and colleagues4,5 was found through a fixed-effects model combining data from different populations. Heterogeneity was null, but a random-effects model (REM) would be advised regardless.
Subject: Cirurgia cardiaca
Coagulacao
Transfusão de componentes sanguineos
language: eng
metadata.dc.publisher.country: Brasil
Publisher: Universidade Federal de Minas Gerais
Publisher Initials: UFMG
metadata.dc.publisher.department: FCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICAS
Rights: Acesso Aberto
metadata.dc.identifier.doi: 10.1016/j.bja.2019.09.017
URI: http://hdl.handle.net/1843/59072
Issue Date: 2019
metadata.dc.url.externa: https://www.bjanaesthesia.org/article/S0007-0912(19)30697-X/fulltext
metadata.dc.relation.ispartof: British Journal of Anaesthesia
Appears in Collections:Artigo de Periódico

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