Kalp cerrahisinde koagulasyon monitörizasyonu

Kanama kardiyopulmoner baypas (KPB) cerrahisinin en önemli komplikasyonlarından biridir. Bu nedenle koagülasyon monitörizasyonu çok önemlidir. Geçmişte koagülopatilerin tanısında daha uzun sürede sonuç verilen laboratuar testleri kullanılırdı, sonuçlar elde edilene dek ampirik transfüzyon yapılırdı. Günümüzde ise bu uygulamanın yerine yatak ba§ı, daha hızlı sonuç veren testler kullanılmaktadır ve soruna yönelik tedavi verilebilmektedir.

Coagulation moni tori zati on in heart surgery

Bleeding is one of the major complication of cardiopulmonary bypass. So coagulation monitorization is an important issue. In the past labarotory tests which take long time for results were used to diagnose coagulopathy and the transfusions made empirical until the results. Today instead of these tests more quick tests are used and so the treatment is problem intended.

___

1. Levy JH, Tanaka KA. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 2003;75(2):715-720.
2. Skubas NJ, Despotis GJ. Optimal management of bleeding complications after cardiac surgery. Semin Cardiothorac Vase Anesth 2001;5(3):217-228.
3. Spiess BD. Maintenance of homeostasis in coagulation during cardiopulmonary bypass. J Cardiothorac Vase Anesth 1999; 13(4 Suppl):2-5.
4. Unsworth-White MJ, Herriot A, Valencia O et al. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg 1995;59(3):664-667.
5. Dacey LJ, Munoz JJ, Baribeau YR, et al. Reexploration for hemorrhage following coronary artery bypass grafting: Incidence and risk factors. Northern New England Cardiovascular Disease Study Group. Arch Surg 1998; 133(4):442-447.
6. Selman M, Intonti MA, Ivert T. Reoperations for bleeding after coronary artery bypass procedures during 25 years. Eur J Cardiothorac Surg 1997;ll(3):521-527.
7. Parr KG, Patel MA, Dekker R, et al. Multivariate predictors of blood product use in cardiac surgery. J Cardithorac Vase Anesth 2003;17(2): 176-181.
8. Despotis GJ, Avidan MS, Hogue CW Jr. Mechanisms and attenuation of hemostatic activation during extracorporeal circulation. AnnThorac Surg 2001;72(5):1821-1831.
9. Shander A, Moskowitz D, Rijhwani TS. The safety and efficacy of "bloodless" cardiac surgery. Semin Cardiothorac Vase Anesth 2005;9(l):53-63.
10. Despotis GJ, Filos KS, Zoys TN, Hogue CW Jr, Spitznagel E, Lappas DG. Factors associated with excessive postoperative blood loss and hemostatic transfusion requirements: A multivariate analysis in cardiac surgical patients. Anesth Analg 1996;82(1): 13-21.
11. Ziats NP, Pankowsky DA, Tierney BP, Ratnoff OD, Anderson JM. Adsorption of Hageman factor (factor XII) and other human plasma proteins biomedical polymer. J Lab Clin Med 1990;116(5):687-696.
12. Chung JH, Gikakis N, Rao AK, Drake TA, Colman RW, Edmunds LH Jr. Pericardial blood activates the extrinsic coagulation pathway during clinical cardiopulmonary bypass. Cirrculationl996;93 (11):2014-2018.
13. Ember JA, Jagels MA, Hugli TE. Characterization of complement anaphylatoxins and their biological responses. In Volankis JE, Frank MM, editors. 3rd Ed. The Human Complement System in Health and Disease. New York, Marcel Dekker;1998:p 241.
14. Kappelmayer J, Bernabei A, Gikakis N, Edmunds LH Jr, Colman RW. Upregulation of Mac-1 surface expression on neutrophils during simulated extracorporeal circulation. J Lab Clin Med 1993; 121(1): 118-126.
15. Teufelsbauer H, Proidl S, Havel M, Vukovich T. Early activation of hemostasis during cardiopulmonary bypass;Evidence for thrombin mediatedhyperfibrinolsis. Thromb Haemost 1992; 68(3):250-252.
16. Greilich PE, Carr ME Jr, Carr SL, Chang AS. Reductions in platelet force development by cardiopulmonary bypass are associated with hemorrhage. Anesth Analg 1995;80(3):459-465.
17. Boldt J, Knothe C, Welters I, Dapper FL, Hempelmann G. Normothermic versus hypothermic cardiopulmonary bypass: do changes in coagulation differ? Ann Thorac Surg 1996;62(1):130-135.
18. Ak K, Atalan N, Tekeli A ve ark. Tromboelastografi ve kalp cerrahisinde kullanımı. Anadolu Kardiyol Derg 2008;8(2):154-162.
19. Dietrich W, Jochum M. Effect of celite and kaolin on activated clotting time in the presence of aprotinin: activated clotting time is reduced by binding of aprotinin to kaolin. J Thorac Cardiovasc Surg 1995; 109(1): 177-178.
20. Miller BE, Mochizuki T, Levy JH, et al. Predicting and treating coagulopathies after cardiopulmonary bypass in children. Anesth Analg 1997;85(6): 1196-1202.
21. Enriquez LJ, Shore-Lesserson L. Point-of-care coagulation testing and transfusion algorithms. Br J Anaesth 2009,103(Suppl 1): 14-22.
22. Jobes DR, Schwartz AJ, Ellison N, Andrews R, Ruffini RA, Ruffini JJ. Monitoring heparin anticoagulation and its neutralization. Ann Thorac Surg 1981 ;31(2): 161-166.
23. Ferring M, Reber G, de Moerloose P, Merlani P, Diby M, Ricou B. Point of care and central laboratory determinations of the aPTT are not interchangeable in surgical intensive care patients. Can J Anaesth 2001 ;48(11): 1155-1160.
24. Lasne D, Fiemeyer A, Chatellier G, Chammas C, Baron JF, Aiach M. A study of platelet function with a new analyzer using high shear stress (PFA 100) in patients undergoing coronary artery bypass graft. Thromb Haemost 2000; 84(5) :794-799.
25. Paniccia R, Antonucci E, Gori AM, et al. Comparison of different methods to evaluate the effect of aspirin on platelet function in high-risk patients with ischemic heart disease receiving dual antiplatelet treatment. Am J Clin Pathol 2007; 128(1): 143-149.
26. Forestier F, Coiffic A, Mouton C, Ekouevi D, Chene G, Janvier G. Platelet function point-of-care tests in post-bypass cardiac surgery: are they relevant? Br J Anaesth 2002;89(5):715-721.
27. Lordkipanidze M, Pharand C, Nguyen TA, Schampaert E, Diodati JG. Assessment of VerifyNow P2Y12 assay accuracy in evaluating clopidogrel-induced platelet inhibition. Ther Drug Monit 2008; 30(3):372-378.
28. Ostrowsky J, Foes J, Warchol M, Tsarovsky G, Blay J. Plateletworks platelet function test compared to the thromboelastograph for prediction of postoperative outcomes. J Extra Corpor Technol 2004;36(2): 149-152.
29. Gerrah R, Brill A, Tshori S, Lubetsky A, Merin G, Varon D. Using cone and plate(let) analyzer to predict bleeding in cardiac surgery. Asian Cardiovasc Thorac Ann 2006; 14(4):310-315.
30. Shore- Lesserson L. Coagulation monitoring. In: Kaplan's Cardiac Anesthesia. 2006 5th edition. USA, Saunders:p 557-583.
31. Luddington RJ. Thromboelastography/thromboelastometry. Clin Lab Haematol 2005;27(2):81-90.
32. Traverso CI, Caprini JA, Arcelus JI. The normal thromboelastogram and its interpretation. Semin Thromb Hemost 1995;21(Suppl 4):7-13.
33. Ti LK, Cheong KF, Chen FG. Prediction of excessive bleeding after coronary artery bypass graft surgery: the influence of timing and heparinase on thromboelastography. J Cardiothorac Vase Anesth 2002;16(5):545-550.
34. Preisman S, Kogan A, Itzkovsky K, Leikin G, Raanani E. Modified thromboelastography evaluation of platelet dysfunction in patients undergoing coronary artery surgery. Eur J Cardiothorac Surg 2010;37(6): 1367-1374.
35. Ak K, Isbir CS, Tetik S ve ark. Thromboelastography-based transfusion algorithm reduces blood product use after elective CABG: A prospective randomized study. J Card Surg 2009; 24(4):404-410.
36. Manspeizer HE, Imai M, Frumento RJ, Parides MK, Mets B, Bennett-Guerrero E. Arterial and venous thrombelastography variables differ during cardiac surgery. Anesth Analg 2001; 93(2):277-281.
37. Gorton HJ, Warren ER, Simpson NA, Lyons GR, Columb MO. Tromboelastography identifies sex-related differences in coagulation. Anesth Analg 2000;91 (5): 1279-1281.
38. Spalding GJ, Hartrumpf M, Sierig T, Oesberg N, Kirschke CG, Albes JM. Cost reduction of perioperative coagulation management in cardiac surgery: value of 'bedside' thrombelastography (ROTEM). Eur J Cardiothorac Surg 2007;31(6):1052-1057.
39. Royston D, von Kier S. Reduced haemostatic factor transfusion using heparinase-modified thrombelastography during cardiopulmonary bypass. Br J Anaesth 2001;86(4):575-578.
40. Turan SK, Aydınlı B, Ayık î ve ark. Açık kalp cerrahisinde tromboelastografinin transfüzyon kararı üzerine etkisi. GKD Anest Yoğ Bak Derg 2006;12(4): 154-159.
41. Ganter MT, Hofer CK. Coagulation monitoring: Current techniques and clinical use of viscoelastic point-of-care coagulation devices. Anesth Analg 2008; 106(5): 1366-1375.
42. Dietrich GV, Schueck R, Menges T, Kiesenbauer NP, Fruehauf AC, Marquardt I. Comparison of four methods for the determination of platelet function in whole blood in cardiac surgery. Thromb Res 1998;89(6):295-301.
43. Fattorutto M, Pradier O, Schmartz D, Ickx B, Barvais L. Does the platelet function analyser (PFA-100) predict blood loss after cardiopulmonary bypass? Br J Anaesth 2003;90(5):692-693.
44. Agarwal S, Coakley M, Reddy K, Riddell A, Mallett S. Quantifying the effect of antiplatelet therapy: a comparison of the platelet function analyzer (PFA-100) and modified thromboelastography (mTEG) with light transmission platelet aggregometry. Anesthesiology 2006;105(4):676-683.