title: Thromboelastogram reduces blood use by inspecting coagulation in heart surgery.
abstract: OBJECTIVE
  Blood transfusion after coronary artery bypass surgery is carried out according to general coagulation tests and blood counts. Our aim was to determine the effects of rotational thromboelastography results on the amount of blood products used in the intraoperative and postoperative periods in coronary artery bypass patients.
  
  
  METHODS
  Our study included 164 patients who underwent coronary artery bypass. A control group was formed from 82 patients picked from hospital records, who had elective coronary artery bypass before the introduction of rotational thromboelastography in our clinic. Blood transfusion was performed in this group according to conventional laboratory data. The study group comprised 82 patients who had elective coronary artery bypass after the introduction of rotational thromboelastography. Blood transfusion was performed in the study group according to rotational thromboelastogram results. The amounts of blood products used in the 2 groups were compared.
  
  
  RESULTS
  There were statistically significant decreases in the intraoperative and postoperative amounts of packed red blood cells (p = 0.012 and p = 0.006) and postoperative whole blood (p = 0.013) used in the study group compared to the control group. Postoperative bleeding was also significantly reduced (p = 0.001) in the study group.
  
  
  CONCLUSIONS
  Blood transfusion is an important issue after coronary artery bypass, and because of the decreased amount of blood products used, a rotational thromboelastography-based blood transfusion algorithm should be applied in patients undergoing coronary artery bypass.
authors.affiliation: Department of Cardiovascular Surgery, Celal Bayar University Faculty of Medicine, Manisa, Turkey fundanizamoglu@yahoo.com.
authors.forename: Funda
authors.initials: F
authors.lastname: Yildirim
authors.affiliation: Department of Cardiovascular Surgery, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
authors.forename: Barıs
authors.initials: B
authors.lastname: Tuncer
authors.affiliation: Department of Cardiovascular Surgery, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Ozbakkaloglu
authors.affiliation: Department of Cardiovascular Surgery, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
authors.forename: Adnan Taner
authors.initials: AT
authors.lastname: Kurdal
authors.affiliation: Department of Anesthesiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
authors.forename: Tulun
authors.initials: T
authors.lastname: Ozturk
authors.affiliation: Department of Cardiovascular Surgery, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Iskesen
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001777:Blood Coagulation; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D013916:Thrombelastography; D013997:Time Factors
keywords: Blood component transfusion; Blood loss; Coronary artery bypass; Thrombelastography; surgical