Diagnostic assessment and therapeutic considerations of excessive bleeding during the immediate postoperative phase after cardiovascular surgery
Keywords:
excessive bleeding, postoperative phase, cardiovascular surgery, surgical reinterventionAbstract
Excessive bleeding during the immediate postoperative phase after cardiovascular surgery is a main complication in the mediate and immediate prognosis in these patients. This topic was reviewed during the last five years and the diagnostic criteria of excessive bleeding during the mentioned post-surgical period were presented, making a special emphasis on the causes and physiopathological elements related to the use of extracorporeal circulation and the beating heart technique. Diagnostic elements of more practical usefulness were included for intensivists, anesthesiologists and cardiologists who face this complication to help them achieve an early diagnosis and an individualized and adequate medical/surgical treatment, thus avoiding serious short-and medium-term complications.
Downloads
References
Leguisamon, Norman Beatriz. Sangrado como complicación en la cirugía cardiaca. Revista Latinoamericana de la CEC. 2006;XIII(1).
2. Pelletier MP, Solymoss S, Lee A, Chiu RCJ. Negative Reexploration for Cardiac Postoperative Bleeding: Can It Be Therapeutic? Ann Thorac Surg. 1998. P. 999-1002.
3. Roque Pifarré. Management of bleeding in cardiovascular surgery. Filadelfia: Hanley & Belfus, inc. 2000. p. 307-322.
4. Bachmann F, McKenna R, Cole ER. The hemostatic mechanism after open-heart surgery. I. Studies on plasma coagulation factors and fibrinolysis in 512 patients after extracorporeal circulation. J Thorac Cardiovasc Surg. 1975;70:76-85.
5. Wasser MN, Houbiers JG, D'Amaro J. The effect of fresh versus stored blood on post-operative bleeding after coronary bypass surgery: a prospective randomized study. Br J Haematol. 1989;72:81-4.
6. Choong CK, Gerrard C, Goldsmith KA, Dunninghan H, Vuylsteke A. Delayed re-exploration for bleeding after coronary artery bypass surgery results in adverse outcomes. Eur J Cardiothorac Surg. 2007;31:834-8.
7. Chuquiure-Valenzuela E . Evaluación del riesgo hemorrágico en cirugía cardíaca. Anestesia Cardiovascular. 2008;31 Supl.1:S121-S126.
8. Dunning J, Versteegh M, Fabbri A. on behalf of the EACTS Audit and Guidelines Commit Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur J Cardiothorac Surg. 2008;34(1):73-92.
9. Chen LQ, Bracey AW, Radovancevic R, Cooper JR, Collard ChD, Vaughn WK, et al. Clopidogrel and bleeding in patients undergoing elective coronary artery by pass grafting. J Thorac Cardiovasc Surg. 2004;128:425-31.
10. Murphy GJ, Reeves BC, Rogers CA, Rizvi SLA, Culliford L, Angelini GD. Increased Mortality, Postoperative Morbidity, and Cost After Red Blood Cell Transfusion in Patients Having Cardiac Surgery. Circulation. 2007;116:2544-52.
11. Scott BH. Blood Transfusion in cardiac Surgery: Is it Appropiate? Annals of Cardiac Aneasthesia. 2007;10:108-12.
12. Practice guidelines for perioperative blood transfusion and adjuvant therapies. Anesthesiology; 2006. p. 198-208.
13. Brown JR. Meta-analysis comparing the effectiveness and adverse outcomes of antifibrinolytic agents in cardiac surgery. Circulation. 2007;115:2801-13.
14. Tanos M, Dunning J. Is recombinant activated factor VII useful for intractable bleeding after after cardiac surgery? Interactive CardioVascular and Thoracic Surgery. 2006;5:493.
15. Bishop CV, Renwick WEP, Hogan C. Recombinant Activated Factor VII: treating postoperative hemorrhage in cardiac surgery. Ann Thorac Surg. 2006;81:875-9.
16. Raivio P, Suojaranta-Ylinen R, Kuitunen A. Recombinant factor VIIa in the treatment of postoperative hemorrhage after cardiac surgery. Ann Thorac Surg. 2005;80:66.
17. Rodríguez A, Martí Pérez JC, Ginarte Rodríguez G, Berdión Sevilla J, Luque Borjas EA. Complicaciones mayores en el período posoperatorio inmediato de la cirugía cardiaca abierta [artículo en línea]. MEDISAN. 2005;9(1). Disponible en: http://bvs.sld.cu/revistas/san/vol9_1_05/san04105.htm
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).