Davidson, Simon; McGrowder, Donovan A.; Keheller, Andrea; Burman, J.
Author Affiliation, Ana.
Can Rotem predict post-operative bleeding and appropriate treatment after surgery?
Journal of Cardiothoracic and Vascular Anesthesia.
Date of Publication
Objective: To evaluate the predictive ability of ROTEM thromboelastometry (Pentapharm, Basel, Switzerland) to identify patients bleeding more than 200 mL/h in the early postoperative period after cardiac surgery. Design: A prospective observational study. Setting: A single university hospital. Participants: Fifty-eight adult male and female patients undergoing primary coronary artery revascularization. Interventions: Blood samples taken preoperatively and at 1, 2, and 3 hours after surgery. Measurements and Main Results: Eight patients bled at least 200 mL/h in the study period. All (100%) had at least 1 abnormal ROTEM result in the study period. Of the 49 patients not found to be bleeding more than 200 mL/h in any of the first 4 postoperative hours, 46 (94%) had at least 1 abnormal ROTEM result. The positive and negative predictive values were 14.8% and 100%, respectively. Conclusions: ROTEM thromboelastometry has poor predictive utility to identify patients who bleed more than 200 mL/h in the early postoperative period after cardiac surgery. However, its negative predictive value was good.....