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Role of Using a Thromboelastometry-Based Protocol for Transfusion Management in Combined Coronary Artery Bypass Grafting and Valve Surgery: A Randomized Clinical Trail

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Abstract

The aim of this study was to evaluate the impact of using a thromboelastometry-based protocol on transfusion requirements in patients undergoing combined coronary artery bypass grafting (CABG) and valve surgery. 80 adult patients scheduled for elective combined CABG and valve surgery were included in this clinical trial study. Patients were randomly allocated to the thromboelastometry (ROTEM) (n = 40) or control groups (n = 40). In the ROTEM group, transfusion was directed according to a thromboelastometry—based protocol. In the control group, transfusion was conducted according to the routine practices including conventional coagulation testing and clinical judgments. Finally, transfusion requirements were compared between groups. Use of thromboelastometry- based protocol resulted in 67% reduction in blood products units’ consumption as well as 23% in the percentage of patients transfused. This reduction was especially evident in relation to fresh frozen plasma (FFP) and platelet consumption. No significant differences were found both in the percentage of patients receiving RBC and number of transfused RBC units. Using thromboelastometry tests incorporated a protocol results in reduction of transfusion requirements in patients undergoing elective combined CABG and valve surgery.

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Authors and Affiliations

  1. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran

    Elham Khalaf-Adeli & Ali Akbar Pourfathollah

  2. Departments of Immunology, Faculty of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran

    Ali Akbar Pourfathollah

  3. Cardiac Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

    Fereidoon Noohi

  4. Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, IranTehran, Iran

    Alireza Alizadeh-Ghavidel

  5. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Mellat park, Valiasr Avenue, Tehran, Iran

    Hooman Bakhshandeh-Abkenar & Seyed Mostafa Alavi

  6. Coagulation Laboratory, Iranian Blood Transfusion Organization, Tehran, Iran

    Roshanak Shamriz

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  1. Elham Khalaf-Adeli
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  2. Ali Akbar Pourfathollah
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  7. Seyed Mostafa Alavi
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Correspondence to Seyed Mostafa Alavi.

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Khalaf-Adeli, E., Pourfathollah, A.A., Noohi, F. et al. Role of Using a Thromboelastometry-Based Protocol for Transfusion Management in Combined Coronary Artery Bypass Grafting and Valve Surgery: A Randomized Clinical Trail. Indian J Hematol Blood Transfus 37, 422–429 (2021). https://doi.org/10.1007/s12288-020-01375-9

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  • DOI: https://doi.org/10.1007/s12288-020-01375-9

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