Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T09:33:38.359Z Has data issue: false hasContentIssue false
  • English
  • Français

Risks associated with bleeding and transfusion: rationale for the optimal management of bleeding after cardiac surgery

Published online by Cambridge University Press:  01 June 2007

G. Despotis ,
M. Renna  and
C. Eby
G. Despotis*
Affiliation:
Washington University School of Medicine, Department of Pathology, Immunology and Anesthesiology, St. Louis, MO, USA
M. Renna
Affiliation:
Royal Brompton Hospital, Department of Cardiothoracic Anaesthesia, USA
C. Eby
Affiliation:
Washington University School of Medicine, Departments of Immunology, Pathology and Medicine, St. Louis, MO, USA
*
Correspondence to: George Despotis, Department of Pathology and Immunology, Box 8118, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA. E-mail: [email protected]; Tel: +(314) 362 6584; Fax: +(314) 362 1461
Get access

Summary

Background and objectives

The main aim of this review is to summarize the literature with respect to transfusion and bleeding risks and the therapeutic strategies with respect to optimal management of perioperative bleeding.

Methods

This review was generated using peer-reviewed manuscripts pertinent to this topic that were identified using a computer-based Medline search.

Results

Although the pathophysiology of many transfusion-related complications are well-documented, the incidence of these complications is changing. Transfusion Medicine initiatives are being implemented to reduce complications, however, the literature is describing new potential problems related to transfusion in addition to identification of new potential pathogens while blood shortages may limit our ability to adequately manage our anemic and bleeding patients. Excessive bleeding after cardiac surgery can result in increased morbidity and mortality related to transfusion and hypoperfusion related complications as well as injury to critical organ systems. Seven of eight studies have demonstrated that use of point-of-care (POC) tests of hemostatic function can facilitate the optimal management of excessive bleeding and reduce transfusion after cardiac surgery. Two randomized prospective studies have demonstrated that point-of-care tests that assess platelet function can identify patients at risk for acquired, platelet-related bleeding that may be attenuated with pharmacologic agents such as DDAVP. The current literature contains fifty publications with over 400 patients that describe the fairly consistent efficacy of off-label use of recombinant factor VIIa to manage intractable, life-threatening bleeding. Most of these publications involve either case reports or case series that describe the use of this agent and therefore do not adequately address the safety of this agent.

Conclusions

There are substantial risks related to excessive bleeding and transfusion. The literature indicates that use of point-of-care diagnostics with a standardized management algorithm can optimize the management of bleeding and reduce transfusion requirements. Recombinant FVIIa has the potential to reduce transfusion and transfusion-related sequelae and may be life-saving in certain circumstances. However, randomized, controlled trials are warranted to assess both the efficacy and, more importantly, the safety of this intervention (i.e., especially with respect to thrombotic complications) in cardiac surgical patients prior to its use as a first line therapy for bleeding or for bleeding prophylaxis. We must continue to carefully investigate the role of new interventions since the ability to reduce use of blood products, to decrease operative time and/or re-exploration rates has important implications for disease prevention and overall patient safety, blood inventory and associated costs as well as overall health care costs.

Keywords

BleedingTransfusionCardiac surgeryBloodBlood componentsBlood risksPoint-of-care diagnostic testsFactor concentrates
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue S40 , June 2007 , pp. 15 - 36
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Moulton, MJ, Creswell, LL, Mackey, ME, Cox, JL, Rosenbloom, M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg 1996; 111: 1037–1046.CrossRefGoogle ScholarPubMed
2.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: 442–447.CrossRefGoogle ScholarPubMed
3.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: 664–667.CrossRefGoogle ScholarPubMed
4.Karkouti, K, Wijeysundera, DN, Yau, TM et al. . The independent association of massive blood loss with mortality in cardiac surgery. Transfusion 2004; 44: 1453–1462.CrossRefGoogle ScholarPubMed
5.Frumento, RJ, O’Malley, CM, Bennett-Guerrero, E. Stroke after cardiac surgery: a retrospective analysis of the effect of aprotinin dosing regimens. Ann Thorac Surg 2003; 75: 479–483.CrossRefGoogle ScholarPubMed
6.Mangano, DT. Aspirin and mortality from coronary bypass surgery. N Engl J Med 2002; 347: 1309–1317.CrossRefGoogle ScholarPubMed
7.Engoren, MC, Habib, RH, Zacharias, A et al. . Effect of blood transfusion on long-term survival after cardiac operation. Ann Thorac Surg 2002; 74: 1180–1186.CrossRefGoogle ScholarPubMed
8.Koch, CG, Li, L, Duncan, AI et al. . Transfusion in coronary artery bypass grafting is associated with reduced long-term survival. Ann Thorac Surg 2006; 81: 1650–1657.CrossRefGoogle ScholarPubMed
9.Goodnough, LT, Brecher, ME, Kanter, MH, AuBuchon, JP. Transfusion medicine: blood transfusion. N Engl J Med 1999; 340: 438–447.CrossRefGoogle ScholarPubMed
10.Walker, RH. Special report: transfusion risks. Am J Clin Pathol 1987; 88: 374–378.CrossRefGoogle ScholarPubMed
11.Goodnough, LT, Shander, A, Brecher, ME. Transfusion medicine: looking to the future. Lancet 2003; 361: 161–169.CrossRefGoogle ScholarPubMed
12.Toy, P, Popovsky, MA, Abraham, E et al. . Transfusion-related acute lung injury: definition and review. Crit Care Med 2005; 1933: 721–726.CrossRefGoogle Scholar
13.Goldman, M, Webert, KE, Arnold, DM et al. . Proceedings of a consensus conference: towards an understanding of TRALI. Transfus Med Rev 2005; 1919: 2–31.CrossRefGoogle Scholar
14.Hebert, PC, Wells, G, Tweeddale, M et al. . Does transfusion practice affect mortality in critically ill patients? Transfusion Requirements in Critical Care (TRICC) Investigators and the Canadian Critical Care Trials Group. Am J Respir Crit Care Med 1997; 155: 1618–1623.CrossRefGoogle ScholarPubMed
15.van de Watering, LM, Hermans, J, Houbiers, JG et al. . Beneficial effects of leukocyte depletion of transfused blood on postoperative complications in patients undergoing cardiac surgery: a randomized clinical trial. Circulation 1998; 97: 562–568.CrossRefGoogle ScholarPubMed
16.Bilgin, YM, van de Watering, LM, Eijsman, L et al. . Double-blind, randomized controlled trial on the effect of leukocyte-depleted erythrocyte transfusions in cardiac valve surgery. Circulation 2004; 109: 2755–2760.CrossRefGoogle ScholarPubMed
17.Wallis, JP, Chapman, CE, Orr, KE, Clark, SC, Forty, JR. Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery. Transfusion 2002; 42: 1127–1134.CrossRefGoogle ScholarPubMed
18.McCullough, J. Complications of transfusion. In: McCullough, J, ed. Transfusion Medicine. New York, NY: McGraw-Hill, 1999: 337–359.Google Scholar
19.Kleinman, S, Caulfield, T, Chan, P et al. . Toward an understanding of transfusion-related acute lung injury: statement of a consensus panel. Transfusion 2004; 1944: 1774–1789.CrossRefGoogle Scholar
20.Silliman, CC, Paterson, AJ, Dickey, WO et al. . The association of biologically active lipids with the development of transfusion-related acute lung injury: a retrospective study. Transfusion 1997; 1937: 719–726.CrossRefGoogle Scholar
21.Blajchman, MA, Beckers, EA, Dickmeiss, E et al. . Bacterial detection of platelets: current problems and possible resolutions. Transfus Med Rev 2005; 19: 259–272.CrossRefGoogle ScholarPubMed
22.Sazama, K. Reports of 355 transfusion-associated deaths: 1976 through 1985. Transfusion 1990; 30: 583–590.CrossRefGoogle ScholarPubMed
23.Linden, JV, Paul, B, Dressler, KP. A report of 104 transfusion errors in New York State. Transfusion 1992; 32: 601–606.CrossRefGoogle ScholarPubMed
24.Dodd, RY, Notari, EP, Stramer, SL. Current prevalence and incidence of infectious disease markers and estimated window-period risk in the American Red Cross blood donor population. Transfusion 2002; 42: 975–979.CrossRefGoogle ScholarPubMed
25.Busch, MP, Glynn, SA, Stramer, SL et al. . A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors. Transfusion 2005; 45: 254–264.CrossRefGoogle ScholarPubMed
26.Kleinman, S, Glynn, SA, Busch, M et al. . The 2003 West Nile virus United States epidemic: the America’s Blood Centers experience. Transfusion 2005; 45: 469–479.CrossRefGoogle ScholarPubMed
27.Edna, TH, Bjerkeset, T. Association between blood transfusion and infection in injured patients. J Trauma 1992; 33: 659–661.CrossRefGoogle ScholarPubMed
28.Agarwal, N, Murphy, JG, Cayten, CG, Stahl, WM. Blood transfusion increases the risk of infection after trauma. Arch Surg 1993; 128: 171–176.CrossRefGoogle ScholarPubMed
29.Triulzi, DJ, Vanek, K, Ryan, DH, Blumberg, N. A clinical and immunologic study of blood transfusion and postoperative bacterial infection in spinal surgery. Transfusion 1992; 32: 517–524.CrossRefGoogle ScholarPubMed
30.Jensen, LS, Andersen, AJ, Christiansen, PM et al. . Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery. Br J Surg 1992; 79: 513–516.CrossRefGoogle ScholarPubMed
31.Jensen, LS, Kissmeyer-Nielsen, P, Wolff, B, Qvist, N. Randomised comparison of leucocyte-depleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery. Lancet 1996; 348: 841–845.CrossRefGoogle ScholarPubMed
32.Edna, TH, Bjerkeset, T. Association between transfusion of stored blood and infective bacterial complications after resection for colorectal cancer. Eur J Surg 1998; 164: 449–456.CrossRefGoogle ScholarPubMed
33.Tartter, PI. The association of perioperative blood transfusion with colorectal cancer recurrence. Ann Surg 1992; 216: 633–638.CrossRefGoogle ScholarPubMed
34.Tartter, PI. Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg 1988; 75: 789–792.CrossRefGoogle ScholarPubMed
35.Vignali, A, Braga, M, Dionigi, P et al. . Impact of a programme of autologous blood donation on the incidence of infection in patients with colorectal cancer. Eur J Surg 1995; 161: 487–492.Google ScholarPubMed
36.Houbiers, JG, van de Velde, CJ, van de Watering, LM et al. . Transfusion of red cells is associated with increased incidence of bacterial infection after colorectal surgery: a prospective study. Transfusion 1997; 37: 126–134.CrossRefGoogle ScholarPubMed
37.Murphy, PJ, Connery, CJr.Hicks, GL, Blumberg, N. Homologous blood transfusion as a risk factor for postoperative infection after coronary artery bypass graft operations. J Thorac Cardiovasc Surg 1992; 104: 1092–1099.CrossRefGoogle ScholarPubMed
38.Chelemer, SB, Prato, BSJrCox, PM, O’Connor, GT, Morton, JR. Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery. Ann Thorac Surg 2002; 73: 138–142.CrossRefGoogle ScholarPubMed
39.Baron, JF, Gourdin, M, Bertrand, M et al. . The effect of universal leukodepletion of packed red blood cells on postoperative infections in high-risk patients undergoing abdominal aortic surgery. Anesth Analg 2002; 94: 529–537.CrossRefGoogle ScholarPubMed
40.Titlestad, IL, Ebbesen, LS , Ainsworth, AP et al. . Leukocyte-depletion of blood components does not significantly reduce the risk of infectious complications. Results of a double-blinded, randomized study. Int J Colorectal Dis 2001; 16: 147–153.CrossRefGoogle Scholar
41.Sauaia, A, Moore, FA, Moore, EE et al. . Early predictors of postinjury multiple organ failure. Arch Surg 1994; 129: 39–45.CrossRefGoogle ScholarPubMed
42.Sauaia, A, Moore, FA, Moore, EE et al. . Multiple organ failure can be predicted as early as 12 h after injury. J Trauma 1998; 45: 291–301.CrossRefGoogle Scholar
43.Moore, FA, Moore, EE, Sauaia, A. Blood transfusion. An independent risk factor for postinjury multiple organ failure. Arch Surg 1997; 132: 620–624.CrossRefGoogle ScholarPubMed
44.Bracey, AW, Radovancevic, R, Riggs, SA et al. . Lowering the hemoglobin threshold for transfusion in coronary artery bypass procedures: effect on patient outcome. Transfusion 1999; 39: 1070–1077.CrossRefGoogle ScholarPubMed
45.Habib, RH, Zacharias, A, Schwann, TA et al. . Role of hemodilutional anemia and transfusion during cardiopulmonary bypass in renal injury after coronary revascularization: implications on operative outcome. Crit Care Med 2005; 33: 1749–1756.CrossRefGoogle ScholarPubMed
46.Fung, MK, Rao, N, Rice, J et al. . Leukoreduction in the setting of open heart surgery: a prospective cohort-controlled study. Transfusion 2004; 44: 30–35.CrossRefGoogle ScholarPubMed
47.Basran, S, Frumento, RJ, Cohen, A et al. . The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery. Anesth Analg 2006; 103: 15–20Table.CrossRefGoogle ScholarPubMed
48.Noninfectious Complications of Blood Transfusion. In: Brecher, ME, ed. AABB Technical Manual, 14th edn. Bethesda, Maryland: AABB, 2002: 586–587.Google Scholar
49.Spiess, BD, Royston, D, Levy, JH et al. . Platelet transfusions during coronary artery bypass graft surgery are associated with serious adverse outcomes. Transfusion 2004; 44: 1143–1148.CrossRefGoogle ScholarPubMed
50.Bucerius, J, Gummert, JF, Borger, MA et al. . Stroke after cardiac surgery: a risk factor analysis of 16,184 consecutive adult patients. Ann Thorac Surg 2003; 75: 472–478.CrossRefGoogle ScholarPubMed
51.Mannucci, PM, Duga, S, Peyvandi, F. Recessively inherited coagulation disorders. Blood 2004; 104: 1243–1252.CrossRefGoogle ScholarPubMed
52.Gomez-Moreno, G, Cutando-Soriano, A, Arana, C, Scully, C. Hereditary blood coagulation disorders: management and dental treatment. J Dent Res 2005; 84: 978–985.CrossRefGoogle ScholarPubMed
53.Peyvandi, F, Duga, S, Akhavan, S, Mannucci, PM. Rare coagulation deficiencies. Haemophilia 2002; 8: 308–321.CrossRefGoogle ScholarPubMed
54.Despotis, GJ, Filos, KS, Zoys, TN et al. . Factors associated with excessive postoperative blood loss and hemostatic transfusion requirements: A multivariate analysis in cardiac surgical patients. Anesth Analg 1996; 82: 13–21.Google ScholarPubMed
55.Kirkpatrick, AW, Chun, R, Brown, R, Simons, RK. Hypothermia and the trauma patient. Can J Surg 1999; 42: 333–343.Google ScholarPubMed
56.Heimark, RL, Kurachi, K, Fujikawa, K, Davie, EW. Surface activation of blood coagulation, fibrinolysis and kinin formation. Nature 1980; 286: 456–460.CrossRefGoogle ScholarPubMed
57.Boisclair, MD, Lane, DA, Philippou, H et al. . Mechanisms of thrombin generation during surgery and cardiopulmonary bypass. Blood 1993; 82: 3350–3357.CrossRefGoogle ScholarPubMed
58.de Haan, J, Boonstra, PW, Monnink, SH, Ebels, T, van Oeveren, W. Retransfusion of suctioned blood during cardiopulmonary bypass impairs hemostasis. Ann Thorac Surg 1995; 59: 901–907.CrossRefGoogle ScholarPubMed
59.Boisclair, MD, Lane, DA, Philippou, H, Sheikh, S, Hunt, B. Thrombin production, inactivation and expression during open heart surgery measured by assays for activation fragments including a new ELISA for prothrombin fragment F1 + 2. Thromb Haemost 1993; 70: 253–258.Google Scholar
60.Menges, T, Wagner, RM, Welters, I et al. . The role of the protein Cthrombomodulin system and fibrinolysis during cardiovascular surgery: influence of acute preoperative plasmapheresis. J Cardiothorac Vasc Anesth 1996; 10: 482–489.CrossRefGoogle ScholarPubMed
61.Hunt, BJ, Parratt, RN, Segal, HC et al. . Activation of coagulation and fibrinolysis during cardiothoracic operations. Ann Thorac Surg 1998; 65: 712–718.CrossRefGoogle ScholarPubMed
62.Slaughter, TF, LeBleu, THJr.Douglas, JM et al. . Characterization of prothrombin activation during cardiac surgery by hemostatic molecular markers. Anesthesiology 1994; 80: 520–526.CrossRefGoogle ScholarPubMed
63.Holloway, DS, Summaria, L, Sandesara, J et al. . Decreased platelet number and function and increased fibrinolysis contribute to postoperative bleeding in cardiopulmonary bypass patients. Thromb Haemost 1988; 59: 62–67.Google ScholarPubMed
64.Yoshihara, H, Yamamoto, T, Mihara, H. Changes in coagulation and fibrinolysis occurring in dogs during hypothermia. Thromb Res 1985; 37: 503–512.CrossRefGoogle ScholarPubMed
65.Tabuchi, N, de Haan, J, Boonstra, PW, van Oeveren, W. Activation of fibrinolysis in the pericardial cavity during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1993; 106: 828–833.CrossRefGoogle ScholarPubMed
66.Stibbe, J, Kluft, C, Brommer, EJ et al. . Enhanced fibrinolytic activity during cardiopulmonary bypass in open-heart surgery in man is caused by extrinsic (tissue-type) plasminogen activator. Eur J Clin Invest 1984; 14: 375–382.CrossRefGoogle Scholar
67.Lu, H, Soria, C, Cramer, EM et al. . Temperature dependence of plasmin-induced activation or inhibition of human platelets. Blood 1991; 77: 996–1005.CrossRefGoogle ScholarPubMed
68.Cramer, EM, Lu, H, Caen, JP et al. . Differential redistribution of platelet glycoproteins Ib and IIb- IIIa after plasmin stimulation. Blood 1991; 77: 694–699.CrossRefGoogle ScholarPubMed
69.Adelman, B, Michelson, AD, Loscalzo, J, Greenberg, J, Handin, RI. Plasmin effect on platelet glycoprotein Ib-von Willebrand factor interactions. Blood 1985; 65: 32–40.CrossRefGoogle ScholarPubMed
70.Despotis, GJ, Joist, JH, Hogue, CW et al. . More effective suppression of hemostatic system activation in patients undergoing cardiac surgery by heparin dosing based on heparin blood concentrations rather than ACT. Thromb Haemostas 1996; 76: 902–908.Google ScholarPubMed
71.Hardy, JF, Perrault, J, Tremblay, N et al. . The stratification of cardiac surgical procedures according to use of blood products: a retrospective analysis of 1480 cases. Can J Anaesth 1991; 38: 511–517.CrossRefGoogle ScholarPubMed
72.Despotis, GJ, Santoro, SA, Spitznagel, E et al. . Prospective evaluation and clinical utility of on-site monitoring of coagulation in patients undergoing cardiac operation. J Thorac Cardiovasc Surg 1994; 107: 271–279.CrossRefGoogle ScholarPubMed
73.Khuri, SF, Wolfe, JA, Josa, M et al. . Hematologic changes during and after cardiopulmonary bypass and their relationship to the bleeding time and nonsurgical blood loss. J Thorac Cardiovasc Surg 1992; 104: 94–107.CrossRefGoogle Scholar
74. Ferraris VA, Ferraris SP, Saha SP, et al. Peri-operative blood transfusion and blood conservation in cardiac surgery: The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Practice Guideline Series. J Thorac Cardiovasc Surg 2007, in press.CrossRefGoogle Scholar
75.Mammen, EF, Koets, MH, Washington, BC et al. . Hemostasis changes during cardiopulmonary bypass surgery. Sem Thromb Hemost 1985; 11: 281–292.CrossRefGoogle ScholarPubMed
76.Bick, RL. Alterations of hemostasis associated with malignancy: etiology, pathophysiology, diagnosis and management. Sem Thromb Hemost 1978; 5: 1–26.CrossRefGoogle ScholarPubMed
77.Harker, LA. Bleeding after cardiopulmonary bypass. N Engl J Med 1986; 314: 1446–1448.CrossRefGoogle ScholarPubMed
78.Kalter, RD, Saul, CM, Wetstein, L, Soriano, C, Reiss, RF. Cardiopulmonary bypass. Associated hemostatic abnormalities. J Thorac Cardiovasc Surg 1979; 77: 427–435.CrossRefGoogle ScholarPubMed
79.Clark, RE, Beauchamp, RA, Magrath, RA et al. . Comparison of bubble and membrane oxygenators in short and long perfusions. J Thorac Cardiovasc Surg 1979; 78: 655–666.CrossRefGoogle Scholar
80.Journois, D, Mauriat, P, Pouard, P et al. . Assessment of coagulation factor activation during cardiopulmonary bypass with a new monoclonal antibody. J Cardiothorac Vasc Anesth 1994; 8: 157–161.CrossRefGoogle ScholarPubMed
81.Gelb, AB, Roth, RI, Levin, J et al. . Changes in blood coagulation during and following cardiopulmonary bypass: lack of correlation with clinical bleeding. Am J Clin Pathol 1996; 106: 87–99.CrossRefGoogle ScholarPubMed
82.Chan, AK, Leaker, M, Burrows, FA et al. . Coagulation and fibrinolytic profile of paediatric patients undergoing cardiopulmonary bypass. Thromb Haemost 1997; 77: 270–277.Google ScholarPubMed
83.Muller, N, Popov-Cenic, S, Buttner, W, Kladetzky, RG, Egil, H. Studies of fibrinolytic and coagulation factors during open heart surgery. II. Postoperative bleeding tendency and changes in the coagulation system. Thromb Res 1975; 7: 588–589.CrossRefGoogle ScholarPubMed
84.Brooks, DH, Bahnson, HT. An outbreak of hemorrhage following cardiopulmonary bypass. Epidemiologic studies. J Thorac Cardiovasc Surg 1972; 63: 449–452.CrossRefGoogle ScholarPubMed
85.Ellison, N, Jobes, DR. Effective hemostasis in the cardiac surgical patient: current status. In: Ellison, N, Jobes, DR, eds. Effective Hemostasis in Cardiac Surgery. Philadelphia: WB Saunders, 1988: 200.Google Scholar
86.Teoh, KH, Young, E, Bradley, CA, Hirsh, J. Heparin binding proteins. Contribution to heparin rebound after cardiopulmonary bypass. Circulation 1993; 88: 420–425.Google ScholarPubMed
87.Meng, ZH, Wolberg, AS, Monroe, DM, Hoffman, III. The effect of temperature and pH on the activity of factor VIIa: implications for the efficacy of high-dose factor VIIa in hypothermic and acidotic patients. J Trauma 2003; 55: 886–891.CrossRefGoogle ScholarPubMed
88.Tanaka, K, Takao, M, Yada, I et al. . Alterations in coagulation and fibrinolysis associated with cardiopulmonary bypass during open heart surgery. J Cardiothorac Anesth 1989; 3: 181–188.CrossRefGoogle ScholarPubMed
89.Woodman, RC, Harker, LA. Bleeding complications associated with cardiopulmonary bypass. [Review]. Blood 1990; 76: 1680–1697.CrossRefGoogle ScholarPubMed
90.Czer, LS. Mediastinal bleeding after cardiac surgery: etiologies, diagnostic considerations, and blood conservation methods. [Review]. J Cardiothorac Anesth 1989; 3: 760–775.CrossRefGoogle ScholarPubMed
91.George, JN, Shattil, SJ. The clinical importance of acquired abnormalities of platelet function. N Engl J Med 1991; 324: 27–39.CrossRefGoogle ScholarPubMed
92.Ferraris, VA, Ferraris, SP, Moliterno, DJ et al. . The Society of Thoracic Surgeons practice guideline series: aspirin and other antiplatelet agents during operative coronary revascularization (executive summary). Ann Thorac Surg 2005; 1979: 1454–1461.CrossRefGoogle Scholar
93.Dietrich, W, Spannagl, M, Schramm, W et al. . The influence of preoperative anticoagulation on heparin response during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1991; 102: 505–514.CrossRefGoogle ScholarPubMed
94.Morris, CD, Vega, JD, Levy, JH et al. . Warfarin therapy does not increase bleeding in patients undergoing heart transplantation. Ann Thorac Surg 2001; 72: 714–718.CrossRefGoogle Scholar
95.McDonald, SB, Kattapurum, BM, Saleem, R et al. . Monitoring hirudin anticoagulation in two patients undergoing cardiac surgery with a plasma-modified act method. Anesthesiology 2002; 97: 509–512.CrossRefGoogle ScholarPubMed
96.Oh, JJ, Akers, WS, Lewis, D, Ramaiah, C, Flynn, JD. Recombinant factor VIIa for refractory bleeding after cardiac surgery secondary to anticoagulation with the direct thrombin inhibitor lepirudin. Pharmacotherapy 2006; 26: 569–577.CrossRefGoogle ScholarPubMed
97.Hein, OV, von Heymann, C, Morgera, S et al. . Protracted bleeding after hirudin anticoagulation for cardiac surgery in a patient with HIT II and chronic renal failure. Artif Organs 2005; 29: 507–510.CrossRefGoogle Scholar
98.Walsham, J, Fraser, JF, Mullany, D et al. . The use of recombinant activated factor VII for refractory bleeding post complex cardiothoracic surgery. Anaesth Intensive Care 2006; 34: 13–20.CrossRefGoogle ScholarPubMed
99.Stratmann, G, deSilva, AM, Tseng, EE et al. . Reversal of direct thrombin inhibition after cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia. Anesth Analg 2004; 98: 1635–1639, table.CrossRefGoogle Scholar
100.Doherty, DC, Ortel, TL, de Bruijn, N, Greenberg, CS, Van Trigt, P3. “Heparin-free” cardiopulmonary bypass: first reported use of heparinoid (Org 10172) to provide anticoagulation for cardiopulmonary bypass. Anesthesiology 1990; 73: 562–565.CrossRefGoogle ScholarPubMed
101.Magnani, HN. Heparin-induced thrombocytopenia (HIT): an overview of 230 patients treated with orgaran (Org 10172). Thromb Haemost 1993; 70: 554–561.Google ScholarPubMed
102.Ganjoo, AK, Harloff, MG, Johnson, WD. Cardiopulmonary bypass for heparin-induced thrombocytopenia: management with a heparin-bonded circuit and enoxaparin. J Thorac Cardiovasc Surg 1996; 112: 1390–1392.CrossRefGoogle ScholarPubMed
103.Robitaille, D, Leclerc, JR, Laberge, R et al. . Cardiopulmonary bypass with a low-molecular-weight heparin fraction (enoxaparin) in a patient with a history of heparin- associated thrombocytopenia [letter]. J Thorac Cardiovasc Surg 1992; 103: 597–599.CrossRefGoogle Scholar
104.Alvarez, JM. Emergency coronary bypass grafting for failed percutaneous coronary artery stenting: increased costs and platelet transfusion requirements after the use of abciximab. J Thorac Cardiovasc Surg 1998; 115: 472–473.CrossRefGoogle ScholarPubMed
105.Gammie, JS, Zenati, M, Kormos, RL et al. . Abciximab and excessive bleeding in patients undergoing emergency cardiac operations. Ann Thorac Surg 1998; 65: 465–469.CrossRefGoogle ScholarPubMed
106.Boehrer, JD, Kereiakes, DJ, Navetta, FI, Califf, RM, Topol, EJ. Effects of profound platelet inhibition with c7E3 before coronary angioplasty on complications of coronary bypass surgery. EPIC Investigators. Evaluation Prevention of Ischemic Complications. Am J Cardiol 1994; 74: 1166–1170.CrossRefGoogle ScholarPubMed
107.Raymond, RE, Lincoff, AM, Booth, JE, Anderson, KM, Miller, DP, Tcheng, JE et al. . Coronary bypass surgery within 12 h of administration of abciximab remains safe despite an increased risk of perioperative bleeding. Eur Heart J 1998; 238.Google Scholar
108.Booth, JA, Patel, VB, Balog, C. Is bleeding risk increased in patients undergoing urgent coronary artery bypass surgery following abciximab? Circulation 1998; 98: I-845.Google Scholar
109.Suzuki, Y, Miyamoto, S, Niewiarowski, S, Edmunds, LH. Integrelin prevents prolonged bleeding times after cardiopulmonary bypass. Ann Thorac Surg 1998; 66: 373–381.CrossRefGoogle ScholarPubMed
110.Yende, S, Wunderink, RG. Effect of clopidogrel on bleeding after coronary artery bypass surgery. Crit Care Med 2001; 29: 2271–2275.CrossRefGoogle ScholarPubMed
111.Hongo, RH, Ley, J, Dick, SE, Yee, RR. The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting. J Am Coll Cardiol 2002; 40: 231–237.CrossRefGoogle ScholarPubMed
112.Ray, JG, Deniz, S, Olivieri, A et al. . Increased blood product use among coronary artery bypass patients prescribed preoperative aspirin and clopidogrel. BMC Cardiovasc Disord 2003: 3.CrossRefGoogle ScholarPubMed
113.Genoni, M, Tavakoli, R, Hofer, C, Bertel, O, Turina, M. Clopidogrel before urgent coronary artery bypass graft. J Thorac Cardiovasc Surg 2003; 126: 288–289.CrossRefGoogle ScholarPubMed
114.Chu, MW, Wilson, SR, Novick, RJ, Stitt, LW, Quantz, MA. Does clopidogrel increase blood loss following coronary artery bypass surgery? Ann Thorac Surg 2004; 78: 1536–1541.CrossRefGoogle ScholarPubMed
115.Karabulut, H, Toraman, F, Evrenkaya, S et al. . Clopidogrel does not increase bleeding and allogenic blood transfusion in coronary artery surgery. Eur J Cardiothorac Surg 2004; 25: 419–423.CrossRefGoogle Scholar
116.Englberger, L, Faeh, B, Berdat, PA et al. . Impact of clopidogrel in coronary artery bypass grafting. Eur J Cardiothorac Surg 2004; 26: 96–101.CrossRefGoogle ScholarPubMed
117.Chen, L, Bracey, AW, Radovancevic, R et al. . Clopidogrel and bleeding in patients undergoing elective coronary artery bypass grafting. J Thorac Cardiovasc Surg 2004; 128: 425–431.CrossRefGoogle ScholarPubMed
118.Kapetanakis, EI, Medlam, DA, Boyce, SW et al. . Clopidogrel administration prior to coronary artery bypass grafting surgery: the cardiologist’s panacea or the surgeon’s headache? Eur Heart J 2005; 26: 576–583.CrossRefGoogle ScholarPubMed
119.Gansera, B, Schmidtler, F, Spiliopoulos, K et al. . Urgent or emergent coronary revascularization using bilateral internal thoracic artery after previous clopidogrel antiplatelet therapy. Thorac Cardiovasc Surg 2003; 51: 185–189.Google ScholarPubMed
120.von Heymann, C, Redlich, U, Moritz, M et al. . Aspirin and clopidogrel taken until 2 days prior to coronary artery bypass graft surgery is associated with increased postoperative drainage loss. Thorac Cardiovasc Surg 2005; 53: 341–345.CrossRefGoogle ScholarPubMed
121.Ascione, R, Ghosh, A, Rogers, CA et al. . In-hospital patients exposed to clopidogrel before coronary artery bypass graft surgery: a word of caution. Ann Thorac Surg 2005; 79: 1210–1216.CrossRefGoogle Scholar
122.NIH. Consensus conference. Fresh-frozen plasma. Indications and risks. JAMA 1985; 253: 551–553.CrossRefGoogle Scholar
123. Practice Guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. Anesthesiology 1996; 84: 732–747.CrossRefGoogle Scholar
124.NIH. Consensus conference. Platelet transfusion therapy. JAMA 1987; 257: 1777–1780.CrossRefGoogle Scholar
125.Goodnough, LT, Johnston, MF, Toy, PT. The variability of transfusion practice in coronary artery bypass surgery. Transfusion Medicine Academic Award Group. JAMA 1991; 265: 86–90.CrossRefGoogle ScholarPubMed
126.Goodnough, LT, Soegiarso, RW, Birkmeyer, JD, Welch, HG. Economic impact of inappropriate blood transfusions in coronary artery bypass graft surgery. Am J Med 1993; 94: 509–514.CrossRefGoogle ScholarPubMed
127.Surgenor, DM, Wallace, EL, Churchill, WH et al. . Red cell transfusions in coronary artery bypass surgery (DRGs 106 and 107). Transfusion 1992; 32: 458–464.CrossRefGoogle ScholarPubMed
128.Stover, EP, Siegel, LC, Parks, R et al. . Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: a 24- institution study. Institutions of the Multicenter Study of Perioperative Ischemia Research Group. Anesthesiology 1998; 88: 327–333.CrossRefGoogle ScholarPubMed
129.Simon, TL, Akl, BF, Murphy, W. Controlled trial of routine administration of platelet concentrates in cardiopulmonary bypass surgery. Ann Thorac Surg 1984; 37: 359–364.CrossRefGoogle ScholarPubMed
130.Milam, JD, Austin, SF, Martin, RF, Keats, AS, Cooley, DA. Alteration of coagulation and selected clinical chemistry parameters in patients undergoing open heart surgery without transfusions. Am J Clin Pathol 1981; 76: 155–162.CrossRefGoogle ScholarPubMed
131.Counts, RB. Transfusion practice in cardiac surgery causes of bleeding in open-heart surgery. Arlington: American Association of Blood Banks, 1991; 1–10.Google Scholar
132.Despotis, GJ, Grishaber, JE, Goodnough, LT. The effect of an intraoperative treatment algorithm on physicians’ transfusion practice in cardiac surgery. Transfusion 1994: 290 34 296.CrossRefGoogle ScholarPubMed
133.Paone, G, Spencer, T, Silverman, NA. Blood conservation in coronary artery surgery. Surgery 1994; 116: 672–677.Google ScholarPubMed
134.Spiess, BD, Gillies, BS, Chandler, W, Verrier, E. Changes in transfusion therapy and reexploration rate after institution of a blood management program in cardiac surgical patients. J Cardiothorac Vasc Anesth 1995; 9: 168–173.CrossRefGoogle ScholarPubMed
135.Nuttall, GA, Oliver, WC, Santrach, PJ et al. . Efficacy of a simple intraoperative transfusion algorithm for nonerythrocyte component utilization after cardiopulmonary bypass. Anesthesiology 2001; 94: 773–781.CrossRefGoogle ScholarPubMed
136.Royston, D, von Kier, S. Reduced haemostatic factor transfusion using heparinase-modified thrombelastography during cardiopulmonary bypass. Br J Anaesth 2001; 1986: 575–578.CrossRefGoogle Scholar
137.Avidan, MS, Alcock, EL, Da Fonseca, J et al. . Comparison of structured use of routine laboratory tests or near-patient assessment with clinical judgement in the management of bleeding after cardiac surgery. Br J Anaesth 2004; 92: 178–186.CrossRefGoogle ScholarPubMed
138.Shore-Lesserson, L, Manspeizer, HE, DePerio, M et al. . Thromboelastography-guided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth Analg 1999; 88: 312–319.CrossRefGoogle ScholarPubMed
139.Capraro, L, Kuitunen, A, Salmenpera, M, Kekomaki, R. On-site coagulation monitoring does not affect hemostatic outcome after cardiac surgery. Acta Anaesthesiol Scand 2001; 45: 200–206.CrossRefGoogle Scholar
140.Despotis, GJ, Levine, V, Saleem, R, Spitznagel, E, Joist, JH. Use of point-of-care test in identification of patients who can benefit from desmopressin during cardiac surgery: a randomised controlled trial. Lancet 1999; 354: 106–110.CrossRefGoogle ScholarPubMed
141.Despotis, GJ, Levine, V, Filos, KS et al. . Evaluation of a new, point-of-care test that measures PAF-mediated acceleration of coagulation in cardiac surgical patients. Anesthesiology 1996; 85: 1311–1323.CrossRefGoogle ScholarPubMed
142.Despotis, GJ, Santoro, SA, Spitznagel, E et al. . On-site prothrombin time, activated partial thromboplastin time, and platelet count. A comparison between whole blood and laboratory assays with coagulation factor analysis in patients presenting for cardiac surgery. Anesthesiology 1994; 80: 338–351.CrossRefGoogle ScholarPubMed
143.Hedner, U, Erhardtsen, E. Potential role for rFVIIa in transfusion medicine. Transfusion 2002; 42: 114–124.CrossRefGoogle ScholarPubMed
144.Arkin, S, Blei, F, Fetten, J et al. . Human coagulation factor FVIIa (recombinant) in the management of limbthreatening bleeds unresponsive to alternative therapies: results from the NovoSeven emergency-use programme in patients with severe haemophilia or with acquired inhibitors. Blood Coagul Fibrinolysis 2000; 11: 255–259.Google ScholarPubMed
145.O’Connell, KA, Wood, JJ, Wise, RP, Lozier, JN, Braun, MM. Thromboembolic adverse events after use of recombinant human coagulation factor VIIa. JAMA 2006; 295: 293–298.CrossRefGoogle ScholarPubMed
146.Goodnough, LT, Lublin, DM, Zhang, L, Despotis, G, Eby, C. Transfusion medicine service policies for recombinant factor VIIa administration. Transfusion 2004; 44: 1325–1331.CrossRefGoogle ScholarPubMed
147.White, B, McHale, J, Ravi, N et al. . Successful use of recombinant FVIIa (Novoseven) in the management of intractable post-surgical intra-abdominal haemorrhage. Br J Haematol 1999; 107: 677–678.CrossRefGoogle ScholarPubMed
148.Martinowitz, U, Kenet, G, Segal, E et al. . Recombinant activated factor VII for adjunctive hemorrhage control in trauma. J Trauma 2001; 51: 431–438.Google ScholarPubMed
149.Weiskopf, RB. Intraoperative use of recombinant activated coagulation factor vII. Anesthesiology 2002; 96: 1287–1289.CrossRefGoogle ScholarPubMed
150.Chuansumrit, A, Chantarojanasiri, T, Isarangkura, P et al. . Recombinant activated factor VII in children with acute bleeding resulting from liver failure and disseminated intravascular coagulation. Blood Coagul Fibrinolysis 2000; 11: S101–S105.CrossRefGoogle ScholarPubMed
151.Mayer, SA, Brun, NC, Begtrup, K et al. . Recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med 2005; 352: 777–785.CrossRefGoogle ScholarPubMed
152.Egan, JR, Lammi, A, Schell, DN, Gillis, J, Nunn, GR. Recombinant activated factor VII in paediatric cardiac surgery. Intensive Care Med 2003; 164: 449–456.Google Scholar
153.Aldouri, M. The use of recombinant factor VIIa in controlling surgical bleeding in non-haemophiliac patients. Pathophysiol Haemost Thromb 2002; 32: 41–46.CrossRefGoogle ScholarPubMed
154.Sheth, S, Dimichele, D, Lee, M et al. . Heart transplant in a factor VIII-deficient patient with a high-titre inhibitor: perioperative management using high-dose continuous infusion factor VIII and recombinant factor VIIa. Haemophilia 2001; 7: 227–232.CrossRefGoogle Scholar
155.Leibovitch, L, Kenet, G, Mazor, K et al. . Recombinant activated factor VII for lifethreatening pulmonary hemorrhage after pediatric cardiac surgery. Pediatr Crit Care Med 2003; 4: 444–446.CrossRefGoogle ScholarPubMed
156.Tokunaga, C, Hiramatsu, Y, Horigome, H et al. . Palliative open heart surgery in an infant with factor VII deficiency. Ann Thorac Surg 2003; 76: 2093–2094.CrossRefGoogle Scholar
157.Pychynska-Pokorska, M, Moll, JJ, Krajewski, W, Jarosik, P. The use of recombinant coagulation factor VIIa in uncontrolled postoperative bleeding in children undergoing cardiac surgery with cardiopulmonary bypass. Pediatr Crit Care Med 2004; 5: 246–250.CrossRefGoogle ScholarPubMed
158.Yilmaz, BT, Alioglu, B, Ozyurek, E et al. . Successful use of recombinant factor VIIa (NovoSeven) during cardiac surgery in a pediatric patient with Glanzmann thrombasthenia. Pediatr Cardiol 2005; 26: 843–845.CrossRefGoogle Scholar
159.Lucey, MA, Myburgh, JA. Recombinant activated factor VII for exsanguinating haemorrhage post bilateral lung transplantation for extra-corporeal lung support-dependent respiratory failure. Anaesth Intensive Care 2003; 1931: 465–469.Google Scholar
160.Verrijckt, A, Proulx, F, Morneau, S, Vobecky, S. Activated recombinant factor VII for refractory bleeding during extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg 2004; 127: 1812–1813.CrossRefGoogle ScholarPubMed
161.Dominguez, TE, Mitchell, M, Friess, SH et al. . Use of recombinant factor VIIa for refractory hemorrhage during extracorporeal membrane oxygenation. Pediatr Crit Care Med 2005; 6: 348–351.CrossRefGoogle ScholarPubMed
162.Wittenstein, B, Ng, C, Ravn, H, Goldman, A. Recombinant factor VII for severe bleeding during extracorporeal membrane oxygenation following open heart surgery. Pediatr Crit Care Med 2005; 6: 473–476.CrossRefGoogle ScholarPubMed
163.Razon, Y, Erez, E, Vidne, B et al. . Recombinant factor VIIa (NovoSeven) as a hemostatic agent after surgery for congenital heart disease. Paediatr Anaesth 2005; 15: 235–240.CrossRefGoogle ScholarPubMed
164.Malherbe, S, Tsui, BC, Stobart, K, Koller, J. Argatroban as anticoagulant in cardiopulmonary bypass in an infant and attempted reversal with recombinant activated factor VII. Anesthesiology 2004; 100: 443–445.CrossRefGoogle Scholar
165.Tanaka, KA, Waly, AA, Cooper, WA, Levy, JH. Treatment of excessive bleeding in Jehovah’s Witness patients after cardiac surgery with recombinant factor VIIa (NovoSeven). Anesthesiology 2003; 98: 1513–1515.CrossRefGoogle ScholarPubMed
166.Hendriks, HG, van der Maaten, JM, de Wolf, J et al. . An effective treatment of severe intractable bleeding after valve repair by one single dose of activated recombinant factor VII. Anesth Analg 2001: 287 93 289, 2nd.CrossRefGoogle ScholarPubMed
167.Bui, JD, Despotis, GD, Trulock, EP, Patterson, GA, Goodnough, LT. Fatal thrombosis after administration of activated prothrombin complex concentrates in a patient supported by extracorporeal membrane oxygenation who had received activated recombinant factor VII. J Thorac Cardiovasc Surg 2002; 124: 852–854.CrossRefGoogle Scholar
168.Zietkiewicz, M, Garlicki, M, Domagala, J et al. . Successful use of activated recombinant factor VII to control bleeding abnormalities in a patient with a left ventricular assist device. J Thorac Cardiovasc Surg 2002; 123: 384–385.CrossRefGoogle Scholar
169.Kastrup, M, von Heymann, C, Hotz, H et al. . Recombinant factor VIIa after aortic valve replacement in a patient with osteogenesis imperfecta. Ann Thorac Surg 2002; 74: 910–912.CrossRefGoogle Scholar
170.Tobias, JD, Berkenbosch, JW, Russo, P. Recombinant factor VIIa to treat bleeding after cardiac surgery in an infant. Pediatr Crit Care Med 2003; 4: 49–51.CrossRefGoogle ScholarPubMed
171.Stratmann, G, Russell, IA, Merrick, SH. Use of recombinant factor VIIa as a rescue treatment for intractable bleeding following repeat aortic arch repair. Ann Thorac Surg 2003; 76: 2094–2097.CrossRefGoogle ScholarPubMed
172.Diprose, P, Gill, R, Herbertson, M. Is recombinant factor VIIa a universal hemostatic agent? In: Vincent, JL, ed. Berlin: Springer-Verlag, 2006: 136–146.Google Scholar
173.Naik, VN, Mazer, CD, Latter, DA, Teitel, JM, Hare, GM. Successful treatment using recombinant factor VIIa for severe bleeding post cardiopulmonary bypass. Can J Anaesth 2003; 50: 599–602.CrossRefGoogle ScholarPubMed
174.O’Connell, NM, Perry, DJ, Hodgson, AJ et al. . Recombinant FVIIa in the management of uncontrolled hemorrhage. Transfusion 2003; 43: 1711–1716.CrossRefGoogle ScholarPubMed
175.Aggarwal, A, Malkovska, V, Catlett, JP, Alcorn, K. Recombinant activated factor VII (rFVIIa) as salvage treatment for intractable hemorrhage. Thromb J 2004; 2: 9.CrossRefGoogle ScholarPubMed
176.Kogan, A, Berman, M, Stein, M, Vidne, BA, Raanani, E. Recombinant factor VIIa use in cardiac surgery--expanding the arsenal therapy for intractable bleeding? J Cardiovasc Surg (Torino) 2004; 45: 569–571.Google ScholarPubMed
177.Vanek, T, Straka, Z, Hrabak, J et al. . Use of recombinant activated factor VII in cardiac surgery for an effective treatment of severe intractable bleeding. Jpn Heart J 2004; 45: 855–860.CrossRefGoogle ScholarPubMed
178.Flynn, JD, Pajoumand, MJrCamp, PC et al. . Recombinant factor VIIa for refractory bleeding following orthotopic heart transplantation. Ann Pharmacother 2004; 38: 1639–1642.CrossRefGoogle ScholarPubMed
179.McIlroy, DR, Silvers, AJ. Recombinant factor VIIa for lifethreatening bleeding in high-risk cardiac surgery despite full-dose aprotinin. Anesth Analg 2004; 99: 27–30.CrossRefGoogle ScholarPubMed
180.Halkos, ME, Levy, JH, Chen, E et al. . Early experience with activated recombinant factor VII for intractable hemorrhage following cardiovascular surgery. Ann Thorac Surg 2005; 67: 1–11.Google Scholar
181.Hyllner, M, Houltz, E, Jeppsson, A. Recombinant activated factor VII in the management of lifethreatening bleeding in cardiac surgery. Eur J Cardiothorac Surg 2005; 28: 254–258.CrossRefGoogle ScholarPubMed
182.von Heymann, C, Redlich, U, Jain, U et al. . Recombinant activated factor VII for refractory bleeding after cardiac surgery--a retrospective analysis of safety and efficacy. Crit Care Med 2005; 33: 2241–2246.CrossRefGoogle ScholarPubMed
183.Raivio, P, Suojaranta-Ylinen, R, Kuitunen, AH. Recombinant factor VIIa in the treatment of postoperative hemorrhage after cardiac surgery. Ann Thorac Surg 2005; 80: 66–71.CrossRefGoogle ScholarPubMed
184.von Heymann, C, Schoenfeld, H, Sander, M et al. . Clopidogrel-related refractory bleeding after coronary artery bypass graft surgery: a rationale for the use of coagulation factor concentrates? Heart Surg Forum 2005; 8: 39–41.CrossRefGoogle ScholarPubMed
185.Gowers, CJ, Parr, MJ. Recombinant activated factor VIIa use in massive transfusion and coagulopathy unresponsive to conventional therapy. Anaesth Intensive Care 2005; 33: 196–200.CrossRefGoogle ScholarPubMed
186.Karkouti, K, Beattie, WS, Wijeysundera, DN et al. . Recombinant factor VIIa for intractable blood loss after cardiac surgery: a propensity score-matched case-control analysis. Transfusion 2005; 45: 26–34.CrossRefGoogle ScholarPubMed
187.Diprose, P, Herbertson, MJ, O’Shaughnessy, D, Gill, RS. Activated recombinant factor VII after cardiopulmonary bypass reduces allogeneic transfusion in complex non-coronary cardiac surgery: randomized double-blind placebo-controlled pilot study. Br J Anaesth 2005; 95: 596–602.CrossRefGoogle ScholarPubMed
188.Bishop, CV, Renwick, WE, Hogan, C et al. . Recombinant activated factor VII: treating postoperative hemorrhage in cardiac surgery. Ann Thorac Surg 2006; 81: 875–879.CrossRefGoogle ScholarPubMed
189.Romagnoli, S, Bevilacqua, S, Gelsomino, S et al. . Small-dose recombinant activated factor VII (NovoSeven) in cardiac surgery. Anesth Analg 2006; 102: 1320–1326.CrossRefGoogle ScholarPubMed
190.DiDomenico, RJ, Massad, MG, Kpodonu, J, Navarro, RA, Geha, AS. Use of recombinant activated factor VII for bleeding following operations requiring cardiopulmonary bypass. Chest 2005; 127: 1828–1835.CrossRefGoogle ScholarPubMed
191.Velik-Salchner, C, Sergi, C, Fries, D et al. . Use of recombinant factor VIIa (Novoseven) in combination with other coagulation products led to a thrombotic occlusion of the truncus brachiocephalicus in a neonate supported by extracorporal membrane oxygenation. Anesth Analg 2005; 101: 924.CrossRefGoogle Scholar
192.Clark, AD, Gordon, WC, Walker, ID, Tait, RC. ‘Last-ditch’ use of recombinant factor VIIa in patients with massive haemorrhage is ineffective. Vox Sang 2004; 86: 120–124.CrossRefGoogle ScholarPubMed
193.Karkouti, K, Yau, TM, Riazi, S et al. . Determinants of complications with recombinant factor VIIa for refractory blood loss in cardiac surgery: [Les determinants de complications avec le facteur VIIa recombinant utilise pour les pertes sanguines refractaires en chirurgie cardiaque]. Can J Anaesth 2006; 53: 802–809.CrossRefGoogle ScholarPubMed
194.Potapov, EV, Pasic, M, Bauer, M, Hetzer, R. Activated recombinant factor VII for control of diffuse bleeding after implantation of ventricular assist device. Ann Thorac Surg 2002; 74: 2182–2183.CrossRefGoogle ScholarPubMed
195.Eikelboom, JW, Bird, R, Blythe, D et al. . Recombinant activated factor VII for the treatment of lifethreatening haemorrhage. Blood Coagul Fibrinolysis 2003; 14: 713–717.CrossRefGoogle ScholarPubMed
196.Tobias, JD, Simsic, JM, Weinstein, S et al. . Recombinant factor VIIa to control excessive bleeding following surgery for congenital heart disease in pediatric patients. J Intensive Care Med 2004; 19: 270–273.CrossRefGoogle ScholarPubMed
197.Mulry, CC, Le Veen, RF, Sobel, M, Lampe, PJ, Burke, DR. Assessment of heparin anticoagulation during peripheral angioplasty. J Vasc Interv Radiol 1991; 2: 133–139.CrossRefGoogle ScholarPubMed
198.Laffan, M, O’Connell, NM, Perry, DJ et al. . Analysis and results of the recombinant factor VIIa extended-use registry. Blood Coagul Fibrinolysis 2003; 14: 35–38.CrossRefGoogle ScholarPubMed
199.Heuer, L, Blumenberg, D. Management of bleeding in a multi-transfused patient with positive HLA class I alloantibodies and thrombocytopenia associated with platelet dysfunction refractory to transfusion of cross-matched platelets. Blood Coagul Fibrinolysis 2005; 16: 287–290.CrossRefGoogle Scholar
200.Lovejoy, AE, Reynolds, TC, Visich, JE et al. . Safety and pharmacokinetics of recombinant factor XIII-A2 administration in patients with congenital factor XIII deficiency. Blood 2006; 108: 57–62.CrossRefGoogle ScholarPubMed
201.Reynolds, TC, Butine, MD, Visich, JE et al. . Safety, pharmacokinetics, and immunogenicity of single-dose rFXIII administration to healthy volunteers. J Thromb Haemost 2005; 3: 922–928.CrossRefGoogle ScholarPubMed
202.Godje, O, Haushofer, M, Lamm, P, Reichart, B. The effect of factor XIII on bleeding in coronary surgery. Thorac Cardiovasc Surg 1998; 46: 263–267.CrossRefGoogle ScholarPubMed
203.Godje, O, Gallmeier, U, Schelian, M, Grunewald, M, Mair, H. Coagulation factor XIII reduces postoperative bleeding after coronary surgery with extracorporeal circulation. Thorac Cardiovasc Surg 2006; 54: 26–33.CrossRefGoogle ScholarPubMed
204.Shainoff, JR, Estafanous, FG, Yared, JP et al. . Low factor XIIIA levels are associated with increased blood loss after coronary artery bypass grafting. J Thorac Cardiovasc Surg 1994; 108: 437–445.CrossRefGoogle ScholarPubMed
205.Blome, M, Isgro, F, Kiessling, AH et al. . Relationship between factor XIII activity, fibrinogen, haemostasis screening tests and postoperative bleeding in cardiopulmonary bypass surgery. Thromb Haemost 2005; 93: 1101–1107.CrossRefGoogle ScholarPubMed
206.Chandler, WL, Patel, MA, Gravelle, L et al. . Factor XIIIA and clot strength after cardiopulmonary bypass. Blood Coagul Fibrinolysis 2001; 12: 101–108.CrossRefGoogle ScholarPubMed
207.Hayward, CP. Inherited platelet disorders. Curr Opin Hematol 2003; 10: 362–368.CrossRefGoogle ScholarPubMed
208.Beck, KH, Bleckmann, U, Mohr, P, Kretschmer, V. DDAVP’s shortening of the bleeding time seems due to plasma von Willebrand factor. Semin Thromb Hemost 1995; 21: 40–43.Google ScholarPubMed
209.Mannucci, PM, Aberg, M, Nilsson, IM, Robertson, B. Mechanism of plasminogen activator and factor VIII increase after vasoactive drugs. Br J Haematol 1975; 30: 81–93.CrossRefGoogle ScholarPubMed
210.Hashemi, S, Palmer, DS, Aye, MT, Ganz, PR. Platelet-activating factor secreted by DDAVP-treated monocytes mediates von Willebrand factor release from endothelial cells. J Cell Physiol 1993; 154: 496–505.CrossRefGoogle ScholarPubMed
211.Salzman, EW, Weinstein, MJ, Weintraub, RM et al. . Treatment with desmopressin acetate to reduce blood loss after cardiac surgery. A double-blind randomized trial. N Engl J Med 1986; 314: 1402–1406.CrossRefGoogle ScholarPubMed
212.Dilthey, G, Dietrich, W, Spannagl, M, Richter, JA. Influence of desmopressin acetate on homologous blood requirements in cardiac surgical patients pretreated with aspirin. J Cardiothorac Vasc Anesth 1993; 7: 425–430.CrossRefGoogle ScholarPubMed
213.Salzman, EW, Weinstein, MJ, Reilly, D, Ware, JA. Adventures in hemostasis. Desmopressin in cardiac surgery. [Review]. Arch Surg 1993; 128: 212–217.CrossRefGoogle ScholarPubMed
214.Sheridan, DP, Card, RT, Pinilla, JC et al. . Use of desmopressin acetate to reduce blood transfusion requirements during cardiac surgery in patients with acetylsalicylic-acid-induced platelet dysfunction. Can J Surg 1994; 37: 33–36.Google ScholarPubMed
215.Gratz, I, Koehler, J, Olsen, D et al. . The effect of desmopressin acetate on postoperative hemorrhage in patients receiving aspirin therapy before coronary artery bypass operations. Journal of Thoracic & Cardiovascular Surgery 1992; 104: 1417–1422.CrossRefGoogle ScholarPubMed
216.Fremes, SE, Wong, BI, Lee, E et al. . Metaanalysis of prophylactic drug treatment in the prevention of postoperative bleeding. Ann Thorac Surg 1994; 58: 1580–1588.CrossRefGoogle ScholarPubMed
217.Czer, LS, Bateman, TM, Gray, RJ et al. . Treatment of severe platelet dysfunction and hemorrhage after cardiopulmonary bypass: reduction in blood product usage with desmopressin. J Am Coll Cardiol 1987; 9: 1139–1147.CrossRefGoogle ScholarPubMed
218.Hackmann, T, Gascoyne, RD, Naiman, SC et al. . A trial of desmopressin (1-desamino-8-D-arginine vasopressin) to reduce blood loss in uncomplicated cardiac surgery. N Engl J Med 1989; 321: 1437–1443.CrossRefGoogle ScholarPubMed
219.Lazenby, WD, Russo, I, Zadeh, BJ et al. . Treatment with desmopressin acetate in routine coronary artery bypass surgery to improve postoperative hemostasis. Circulation 1990; 82: IV413–IV419.Google ScholarPubMed
220.Ansell, J, Klassen, V, Lew, R et al. . Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study. J Thorac Cardiovasc Surg 1992; 104: 117–123.CrossRefGoogle ScholarPubMed
221.Casas, JI, Zuazu-Jausoro, I, Mateo, J et al. . Aprotinin versus desmopressin for patients undergoing operations with cardiopulmonary bypass. A double-blind placebo-controlled study. J Thorac Cardiovasc Surg 1995; 110: 1107–1117.CrossRefGoogle ScholarPubMed
222.Temeck, BK, Bachenheimer, LC, Katz, NM, Coughlin, SS, Wallace, RB. Desmopressin acetate in cardiac surgery: a double-blind, randomized study. South Med J 1994; 87: 611–615.CrossRefGoogle ScholarPubMed
223.de Prost, D, Barbier-Boehm, G, Hazebroucq, J et al. . Desmopressin has no beneficial effect on excessive postoperative bleeding or blood product requirements associated with cardiopulmonary bypass. Thromb Haemost 1992; 68: 106–110.Google ScholarPubMed
224.Mongan, PD, Hosking, MP. The role of desmopressin acetate in patients undergoing coronary artery bypass surgery. A controlled clinical trial with thromboelastographic risk stratification. Anesthesiology 1992; 77: 38–46.CrossRefGoogle ScholarPubMed
225.Alvarez, JM, Jackson, LR, Chatwin, C, Smolich, JJ. Low-dose postoperative aprotinin reduces mediastinal drainage and blood product use in patients undergoing primary coronary artery bypass grafting who are taking aspirin: a prospective, randomized, double-blind, placebo-controlled trial. J Thorac Cardiovasc Surg 2001; 122: 457–463.CrossRefGoogle Scholar
226.Cicek, S, Demirkilic, U, Ozal, E et al. . Postoperative use of aprotinin in cardiac operations: an alternative to its prophylactic use. J Thorac Cardiovasc Surg 1996; 112: 1462–1467.CrossRefGoogle ScholarPubMed
227.Ray, MJ, Hales, MM, Brown, L, O’Brien, MF, Stafford, EG. Postoperatively administered aprotinin or epsilon aminocaproic acid after cardiopulmonary bypass has limited benefit. Ann Thorac Surg 2001; 72: 521–526.CrossRefGoogle ScholarPubMed
228.Tatar, H, Cicek, S, Demirkilic, U et al. . Topical use of aprotinin in open heart operations. Ann Thorac Surg 1993; 55: 659–661.CrossRefGoogle ScholarPubMed
229.Goodnough, LT, Shander, A, Spence, R. Bloodless medicine: clinical care without allogeneic blood transfusion. Transfusion 2003; 43: 668–676.CrossRefGoogle ScholarPubMed
230.Lawson, JH. The clinical use and immunologic impact of thrombin in surgery. Semin Thromb Hemost 2006; 32: 98–110.CrossRefGoogle ScholarPubMed
231.Lundblad, RL, Bradshaw, RA, Gabriel, D et al. . A review of the therapeutic uses of thrombin. Thromb Haemost 2004; 91: 851–860.Google ScholarPubMed