Cardiothoracic & vascular anesthesia
Protracted fibrinolysis resistance following cardiac surgery with cardiopulmonary bypass: A prospective observational study of clinical associations and patient outcomes
Authors' conclusion
This observational hypothesis-generating study in patients undergoing cardiac surgery with cardiopulmonary bypass demonstrated an association between the severity of fibrinolysis resistance, measured on the first post-operative day, and the need for extended postoperative ICU level support.
Study context
- Population
- Patients after cardiac surgery with cardiopulmonary bypass (CPB)
- Participants
- 52 patients
- Outcome
- Kinetics of fibrinolysis recovery post-CPB (ClotPro TPA-induced clot lysis time, TPA LT) and its correlation with surgical risk, disease severity, organ dysfunction and ICU LOS
Methodological detailshypothesis-generating
- Hypothesis-generating
Main finding
As reported in the abstract
Correlations of TPA LT on post-operative day 1 · first post-operative day (D1)
- EuroScore II, Spearman's rho (p < .01)
- .39
- Time on CPB, rho (p = .04)
- .35
- APACHE II, rho (p < .001)
- .52
- SOFA, rho (p < .001)
- .51
- Duration of invasive ventilation, rho (p < .01)
- .46
- eGFR, rho (p < .001)
- −.65
Observational data: associations, not effects.
Further findings
ICU LOS (generalized linear regression with TPA LT, CPB run time, organ function markers)
| OR (95% CI) | P value | ||
|---|---|---|---|
| TPA LTOnly TPA LT independently associated | 1.03 (1.01–1.05) | P = 0.01 | |
| 0.512Odds ratio (log scale) |
Mediation by renal function (latent variables analysis)
- Association between TPA LT and ICU LOS not mediated by renal function
Original publication
Protracted fibrinolysis resistance following cardiac surgery with cardiopulmonary bypass: A prospective observational study of clinical associations and patient outcomes. Acta Anaesthesiol Scand. Published 18 March 2024. doi:10.
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