[Coagulation disorders in the context of cardiac surgery - Clinical basics and mechanism based therapy].
Intra- and postoperative bleeding disorders are common in cardiac surgery. The etiology of perioperative coagulopathy frequently becomes apparent as a combination of several acquired and inherited disorders. Differential diagnosis of microvascular bleeding include altered homeostasis (e.g. anemia, hypothermia, acidosis, hypocalcemia), impaired primary hemostasis, antithrombotic medication, dilutive and consumptive coagulopathy, fibrinolysis and the absence or deficiency of coagulation factors. Timely detection of underlying pathology and subsequent rigorous treatment has the potential to minimize perioperative transfusion requirements, prevent resternotomy and improve patient outcome remarkably. Point-of-care-systems can provide fast bed-sided analysis, which contribute to early diagnosis and intervention. Individual and regularly revised algorithms, adapted to the individualized institutional infrastructure, may facilitate resource-saving treatment of perioperative coagulopathy.
Marc G
MG
Lazarus
Thorsten M
TM
Smul
Norbert
N
Roewer
Peter
P
Kranke
D000925:Anticoagulants / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000628:therapy*; D001780:Blood Coagulation Tests; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003937:Diagnosis, Differential; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D019990:Perioperative Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control / Q000628:therapy; D065227:Transfusion Reaction
D000925:Anticoagulants