Hematological disorders in cardiac surgery with extracorporeal circulation: thromboelastogram as a transfusion strategy.

Abstract

In cardiac surgery with extracorporeal circulation, bleeding is one of the most serious and frequent complications, it determines a high consumption of blood products. A consensus has now been reached, in which the use of blood products whenever possible should be reduced and avoided, since it has been associated with serious adverse effects such as acute lung injury, increased incidence of nosocomial infections, circulatory overload, renal, in addition to prolonging the permanence of patients in the intensive care unit, thus increasing morbidity and mortality. The rotational thromboelastometry test ROTEM is a monitoring technique that analyzes the haemostatic process as a whole, evaluating the kinetic and viscoelastic characteristics of the clot, quickly and accurately, its application being very useful and suggestive in these clinical scenarios. It thus becomes a useful tool in the management of bleeding, helping to clarify the different causes of coagulopathy, focusing an effective and effective treatment, significantly reducing the margin of complications and therefore promoting the recovery of patients.