Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery

dc.creatorAndre Soares Santos
dc.creatorKenya Valeria Micaela de Souza Noronha
dc.creatorMonica Viegas Andrade
dc.date.accessioned2023-10-02T20:38:03Z
dc.date.accessioned2025-09-08T23:37:03Z
dc.date.available2023-10-02T20:38:03Z
dc.date.issued2019
dc.identifier.doi10.1016/j.bja.2019.09.017
dc.identifier.issn0007-0912
dc.identifier.urihttps://hdl.handle.net/1843/59072
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofBritish Journal of Anaesthesia
dc.rightsAcesso Aberto
dc.subjectCirurgia cardiaca
dc.subjectCoagulacao
dc.subjectTransfusão de componentes sanguineos
dc.subject.otherBleeding
dc.subject.otherCoagulopathy
dc.subject.otherPoint of care testing
dc.subject.otherTransfusion
dc.subject.otherViscoelastic blood testconcentration
dc.titleRoutine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery
dc.typeArtigo de periódico
local.citation.epagee16
local.citation.issue1
local.citation.spagee1
local.citation.volume124
local.description.resumoThe 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.
local.publisher.countryBrasil
local.publisher.departmentFCE - DEPARTAMENTO DE CIÊNCIAS ECONÔMICAS
local.publisher.initialsUFMG
local.url.externahttps://www.bjanaesthesia.org/article/S0007-0912(19)30697-X/fulltext

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