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Master Thesis

Apport de la thromboélastographie dans la prise en charge transfusionnelle des hémorragies en chirurgie cardiovasculaire : évolution des pratiques à l'Hôpital Européen Georges Pompidou

Abstract : Objective: cardiac surgery is associated with numerous hemorrhage complications. Thromboelastography (TEG) is a point-of-care monitoring of hemostasis with potential benefits in reducing perioperative transfusions. Our goal was to evaluate changes in beeding and transfusion during TEG implementation at Georges Pompidou European Hospital (HEGP) in patients undergoing cardiac surgery with extracorporeal circulation. Material and methods: we conducted an interventional single-center study between January 12th 2017 and April 11 2018. Patients were recruited if they had bleeding after heparin antagonization. Eight months observational period (control group) precede 8 months TEG-based management period (TEG group). Results: thirty five patients were enrolled at HEGP : 22 in control group and 13 in TEG group. Chest tube drainage was significantly reduced 12, 24 hours ant total post-operatively in TEG group : 800 mL, 1120 mL and 1590 mL respectively, compared to control group : 1214 mL, 1806 mL and 2700 mL (p < 0.01). Greater antithrombotic treated-patients number was found as a confounder in control group, warranted with multivariate analysis (p = 0.029). Conclusions: the use of TEG-guided transfusions algorithm at HEGP was not an independant factor for minimizing postoperative bleeding, nor blood products consumption.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02507584
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Submitted on : Monday, February 8, 2021 - 4:37:49 PM
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Khou André Ly. Apport de la thromboélastographie dans la prise en charge transfusionnelle des hémorragies en chirurgie cardiovasculaire : évolution des pratiques à l'Hôpital Européen Georges Pompidou. Médecine humaine et pathologie. 2019. ⟨dumas-02507584⟩

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