Effect of ultrafiltration on whole blood coagulation profile during cardiopulmonary bypass in cardiac surgery : a retrospective analysis
BACKGROUND: Ultrafiltration (UF) would enhance coagulation profiles by concentrating coagulation elements during cardiopulmonary bypass (CPB) for cardiac surgery.
METHODS: We retrospectively reviewed electronic medical records of 75 patients who had undergone cardiac surgery with rotational thromboelastometry-based coagulation management in a university hospital and analyzed the UF-induced changes in the maximum clot firmness (MCF) of extrinsically activated test with tissue factor (EXTEM) during CPB in 30 patients.
RESULTS: The median volume of filtered-free water was 1,350 ml, and median hematocrit was significantly increased from 22.5% to 25.5%. As the primary measure, UF significantly increased the median MCF-EXTEM from 48.0 mm to 50.5 mm (P = 0.015, effect size r = 0.44). The area under the receiver operating characteristic curve pre-UF MCF-EXTEM for discrimination of any increase of MCF-EXTEM after applying UF was 0.89 (95% CI [0.77, 1.00], P < 0.001), and its cut-off value was 50.5 mm (specificity of 81.8% and sensitivity of 84.2% in Youden's J statistic). In the secondary analyses using the cut-off value, UF significantly increased the median MCF-EXTEM from 40.5 mm to 42.5 mm in 18 patients with pre-UF MCF-EXTEM ≤ 50.5 mm. However, it did not increase MCF-EXTEM in 12 patients with pre-UF MCF-EXTEM > 50.5 mm. There was a significant interaction between pre-UF MCF-EXTEM values and applying UF (P < 0.001 for the subgroup, P = 0.046 for UF, P = 0.003 for interaction).
CONCLUSIONS: Applying UF improved clot firmness, and the improvement was more pronounced when pre-UF MCF-EXTEM had been reduced during CPB.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Korean journal of anesthesiology - 77(2024), 2 vom: 18. Apr., Seite 236-245 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, Jaemoon [VerfasserIn] |
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| Links: |
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| Themen: |
Blood coagulation |
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| Anmerkungen: |
Date Completed 02.04.2024 Date Revised 03.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.4097/kja.23698 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367775522 |
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| 100 | 1 | |a Lee, Jaemoon |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effect of ultrafiltration on whole blood coagulation profile during cardiopulmonary bypass in cardiac surgery |b a retrospective analysis |
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| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Ultrafiltration (UF) would enhance coagulation profiles by concentrating coagulation elements during cardiopulmonary bypass (CPB) for cardiac surgery | ||
| 520 | |a METHODS: We retrospectively reviewed electronic medical records of 75 patients who had undergone cardiac surgery with rotational thromboelastometry-based coagulation management in a university hospital and analyzed the UF-induced changes in the maximum clot firmness (MCF) of extrinsically activated test with tissue factor (EXTEM) during CPB in 30 patients | ||
| 520 | |a RESULTS: The median volume of filtered-free water was 1,350 ml, and median hematocrit was significantly increased from 22.5% to 25.5%. As the primary measure, UF significantly increased the median MCF-EXTEM from 48.0 mm to 50.5 mm (P = 0.015, effect size r = 0.44). The area under the receiver operating characteristic curve pre-UF MCF-EXTEM for discrimination of any increase of MCF-EXTEM after applying UF was 0.89 (95% CI [0.77, 1.00], P < 0.001), and its cut-off value was 50.5 mm (specificity of 81.8% and sensitivity of 84.2% in Youden's J statistic). In the secondary analyses using the cut-off value, UF significantly increased the median MCF-EXTEM from 40.5 mm to 42.5 mm in 18 patients with pre-UF MCF-EXTEM ≤ 50.5 mm. However, it did not increase MCF-EXTEM in 12 patients with pre-UF MCF-EXTEM > 50.5 mm. There was a significant interaction between pre-UF MCF-EXTEM values and applying UF (P < 0.001 for the subgroup, P = 0.046 for UF, P = 0.003 for interaction) | ||
| 520 | |a CONCLUSIONS: Applying UF improved clot firmness, and the improvement was more pronounced when pre-UF MCF-EXTEM had been reduced during CPB | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood coagulation | |
| 650 | 4 | |a Cardiac surgical procedures | |
| 650 | 4 | |a Cardiopulmonary bypass | |
| 650 | 4 | |a Retrospective studies | |
| 650 | 4 | |a Thoracic surgery | |
| 650 | 4 | |a Thrombelastography | |
| 650 | 4 | |a Ultrafiltration. | |
| 700 | 1 | |a Lee, Dong-Kyu |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Won-Kyoung |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sookyung |e verfasserin |4 aut | |
| 700 | 1 | |a Oh, Chung-Sik |e verfasserin |4 aut | |
| 700 | 1 | |a Görlinger, Klaus |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Tae-Yop |e verfasserin |4 aut | |
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