Impact of Sonoclot hemostasis analysis after cardiopulmonary bypass on postoperative hemorrhage in cardiac surgery

Tatsuya Yamada, Nobuyuki Katori, Kenichi A. Tanaka, Junzo Takeda

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: The Sonoclot Analyzer provides a functional test of whole blood coagulation by measuring the viscous property of the blood sample. In this study, we used a modified Sonoclot assay, using cuvettes with a glass bead activator containing heparinase, and compared the Sonoclot data before and after cardiopulmonary bypass (CPB) to assess the usefulness in predicting postoperative hemorrhage. Methods: In 41 cardiac surgery patients, Sonoclot data were obtained immediately after heparin administration (pre-bypass) and just before protamine administration (post-bypass). Excessive bleeding was defined as chest tube drainage greater than 2 ml·kg-1 ·h-1 in 1 h during the first 4 h after surgery. Results: There were no significant differences in Sonoclot values before and after CPB in patients with acceptable bleeding (n = 29). In patients with excessive bleeding (n = 12), Sonoclot variables reflecting fibrin formation (activated clotting time [ACT], rate of fibrin formation [clot rate], and peak clot signal) were preserved after CPB; however, the variables reflecting platelet-fibrin interaction (time to peak, peak angle, and clot retraction rate) were significantly different from their respective pre-bypass values. Sonoclot analysis showed impairment of clot maturation after CPB in patients with excessive postoperative bleeding. Conclusion: Our results suggest that abnormal postoperative hemorrhage can be predicted by Sonoclot analysis with a new glass bead-activated heparinase test performed after CPB.

Original languageEnglish
Pages (from-to)148-152
Number of pages5
JournalJournal of Anesthesia
Volume21
Issue number2
DOIs
Publication statusPublished - 2007 May

Fingerprint

Postoperative Hemorrhage
Hemostasis
Cardiopulmonary Bypass
Thoracic Surgery
Fibrin
Heparin Lyase
Hemorrhage
Glass
Blood Coagulation Tests
Clot Retraction
Chest Tubes
Protamines
Heparin
Drainage
Blood Platelets

Keywords

  • Cardiac surgery
  • Postoperative hemorrhage
  • Sonoclot

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Impact of Sonoclot hemostasis analysis after cardiopulmonary bypass on postoperative hemorrhage in cardiac surgery. / Yamada, Tatsuya; Katori, Nobuyuki; Tanaka, Kenichi A.; Takeda, Junzo.

In: Journal of Anesthesia, Vol. 21, No. 2, 05.2007, p. 148-152.

Research output: Contribution to journalArticle

Yamada, Tatsuya ; Katori, Nobuyuki ; Tanaka, Kenichi A. ; Takeda, Junzo. / Impact of Sonoclot hemostasis analysis after cardiopulmonary bypass on postoperative hemorrhage in cardiac surgery. In: Journal of Anesthesia. 2007 ; Vol. 21, No. 2. pp. 148-152.
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