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Postoperative Coagulation and Bleeding: Monitoring and Hematologic Management After Adult Cardiac Surgery

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Postoperative Critical Care for Adult Cardiac Surgical Patients

Abstract

There is a never-ending physiologic balance between thrombotic and antithrombotic factors in vivo. However, this balance changes to a major challenge in cardiac surgery which is a potential dilemma for postoperative care: what is the ideal goal in postoperative management of bleeding and hemostasis in these patients, especially when considering the importance of preoperative, intraoperative, and postoperative factors on the thrombosis and coagulation cascade?

The postoperative management of coagulation in adult cardiac surgery patients follows the rules of medicine with a specific focus on medication history, all coexisting diseases or comorbidities, including but not limited to previous events in the coagulation system. Postoperative test especially point-of-care battery of tests has an important role in the diagnosis of underlying conditions, TEG® and ROTEM® being part of these tests. Treatment includes pharmaceutical agents, blood component therapy, and surgical management, each of them with specific benefits, merits, and potential disadvantages which are discussed in detail in this chapter.

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Authors and Affiliations

  1. Cardiothoracic Surgery, Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA

    Dominic Emerson M.D.

  2. Faculty of Medicine, Cardiac Anesthesiology Department, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Dabbagh M.D.

  3. Cardiac Anesthesiology Fellowship Program, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Dabbagh M.D.

Authors
  1. Dominic Emerson M.D.
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  2. Ali Dabbagh M.D.
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Correspondence to Ali Dabbagh M.D. .

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Editors and Affiliations

  1. Shahid Beheshti Univ Med Sci, Sa'adat Abad, Tehran, Iran

    Ali Dabbagh

  2. Cedars-Sinai Heart Institute, Los Angeles, California, USA

    Fardad Esmailian

  3. Brigham and Women's Hospital, Boston, Massachusetts, USA

    Sary Aranki

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Emerson, D., Dabbagh, A. (2018). Postoperative Coagulation and Bleeding: Monitoring and Hematologic Management After Adult Cardiac Surgery. In: Dabbagh, A., Esmailian, F., Aranki, S. (eds) Postoperative Critical Care for Adult Cardiac Surgical Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-75747-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-75747-6_7

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  • Online ISBN: 978-3-319-75747-6

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