title: Microporous polysaccharide hemosphere absorbable hemostat use in cardiothoracic surgical procedures.
abstract: BACKGROUND
  Topical hemostatic agents are used to reduce bleeding and transfusion need during cardiothoracic surgery. We report our experience with Arista® AH Absorbable Hemostatic Particles (Arista® AH), a novel plant-based microporous polysaccharide hemostatic powder.
  
  
  METHODS
  Data were retrospectively collected for patients (n = 240) that received cardiothoracic surgery at our institution from January 2009 to January 2013 with (n = 103) or without (n = 137) the use of Arista® AH. Endpoints included protamine to skin closure time (hemostasis time), cardiopulmonary bypass time, quantity of Arista® AH applied, intraoperative blood product usage, intraoperative blood loss, chest tube output 48 hours postoperatively, blood products required 48 hours postoperatively, length of stay in the intensive care unit, 30-day morbidity, and 30-day mortality.
  
  
  RESULTS
  240 patients (176 M: 64 F) underwent 240 cardiothoracic procedures including heart transplantation (n = 53), cardiac assist devices (n = 113), coronary artery bypass grafts (n = 20), valve procedures (n = 19), lung transplantation (n = 17), aortic dissection (n = 8), and other (n = 10). Application of Arista® AH led to significant reduction in hemostasis time versus the untreated control group (Arista® AH: 93.4 ± 41 min. vs.
  
  
  METHODS
  107.6 ± 56 min., p = 0.02). Postoperative chest tube output in the first 48 hours was also significantly reduced (Arista® AH: 1594 ± 949 mL vs.
  
  
  METHODS
  2112 ± 1437 mL, p < 0.001), as well as transfusion of packed red blood cells (Arista® AH: 2.4 ± 2.5 units vs.
  
  
  METHODS
  4.0 ± 5.1 units, p < 0.001). There was no significant difference in 30-day mortality or postoperative complications.
  
  
  CONCLUSIONS
  Use of Arista® AH in complex cardiothoracic surgery resulted in a significant reduction in hemostasis time, postoperative chest tube output, and need for postoperative blood transfusion.
authors.affiliation: Houston Methodist Hospital, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA. BAbruckner@houstonmethodist.org.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Bruckner
authors.forename: Lance N
authors.initials: LN
authors.lastname: Blau
authors.forename: Limael
authors.initials: L
authors.lastname: Rodriguez
authors.forename: Erik E
authors.initials: EE
authors.lastname: Suarez
authors.forename: Uy Q
authors.initials: UQ
authors.lastname: Ngo
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Reardon
authors.forename: Matthias
authors.initials: M
authors.lastname: Loebe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013213:Starch / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C527600:Arista; D006490:Hemostatics; D013213:Starch
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