Title: ROLE OF [THROMBELASTOGRAPH®
ANALYSIS] (TEG[®]) IN OPEN
HEART SURGERY
Author(s): Uday Gandhe, M. Butani, S. Pandey, K. Pandey
Address: Department of Anaesthesia and CVTS P.D. Hinduja
National Hospital & M.R.C., Mumbai
Introduction:
Thromboelastograph® analysis (TEG[®]) provides an effective and convenient means of monitoring
whole blood coagulation. It evaluates the elastic properties of whole blood and provides
information concerning coagulability.
Non surgical bleeding after cardiac surgery still remains an
unpredictable and troublesome problem that frequently complicates peri-operative period.
Empiric prophylaxis with blood products or pharmacologic agents can be both risky and
expensive.
Aim:
To study the role of TEG[®] in reducing post operative bleeding, use of blood products and
rate of re-exploration.
Materials & Methods:
400 patients undergoing various open heart surgery were included in this study. In half of
these patients, the coagulation was monitored using TEG[®] perioperatively (Group-A).
Remaining half of the patients were subjected to various routine coagulation tests
(Group-B). Patients on antithrombolytic drugs were excluded from this study. Blood and
other blood products were administered as indicated by tests carried out in two different
groups.
Results:
Post operative haemorrhage and use of blood products (FFP, Platelets, etc.) was reduced by
50% in Group A patients. Re-exploration rate in Group A was 1% while in Group B was 3%.
Conclusion:
Postoperative blood loss was found to be less in group A patients. Use of
TEG[®] considerably
helps in management of post operative coagulopathy by differentiating surgical bleeding
from other causes.
