Correlation between perioperative thromboelastogram and coagulation test in patients undergoing cardiac surgery

Abstract

Objective To investigate the correlation among preoperative and postoperative thromboelastography (TEG) and routine coagulation tests in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB), and detect the changes of TEG and coagulation test pre-CPB and post-CPB and the values in perioperative management of cardiac surgery. Methods In the current study, TEG, routine coagulation test and platelet count of hemoglobin (Hb) and blood platelet (PLT) were measured before and after cardiac surgery under CPB. The correlation between reaction time (R), clotting time (K), α-Angle (Angle), maximum amplitude (MA), coagulation index (CI) and prothrombin time (PT), international standard ratio (INR), activated partial coagulation time (APTT), thrombin time (TT), fibrinogen (Fib), Hb, PLT, CPB time and aortic occlusion (OA) time was analyzed. Results Forty-seven patients were enrolled in the study. Postoperative K value and Fib were statistically significantly increased compared with the preoperative levels (P<0.05). Postoperative Hb and PLT were decreased significantly compared with the preoperative levels (P<0.05). The correlations analysis among pre-operation (pre) items and post-operation (po) items including TEG, routine coagulation test, Hb and PLT showed that correlations were existed in these following indicators: MApre and PLTpre, INRpre and PTpre, Rpre and Kpre, Rpre and Anglepre, Rpre and CIpre, Kpre and Anglepre, Kpre and MApre, Kpre and CIpre, Anglepre and MApre, Anglepre and CIpre, MApre and CIpre, Kpo and Kpre, Kpo and Anglepre, Kpo and MApre, Anglepo and Kpre, Anglepo and Anglepre, Anglepo and MApre, Anglepo and Kpo, CIpo and Rpo, CIpo and Kpo, CIpo and Anglepo, MApo and CPB, CPB and OA, Hbpo and Hbpre, PTpo and Hbpre, INRpo and Hbpre, INRpo and PTpo, among which Rpre and Anglepre, Rpre and CIpre,Kpre and Anglepre, Kpre and MApre, Kpre and CIpre, Kpo and Anglepre, Kpo and MApre, Anglepo and Kpre, Anglepo and Kpo, CIpo and Rpo, CIpo and Kpo, MApo and CPB, PTpo and Hbpre, INRpo and Hbpre were negatively correlated, and the others were positively correlated. Conclusions TEG, coagulation test, Hb and PLT are widely correlated after CPB in patients undergoing cardiac valve surgery. TEG and coagulation test play an important role in monitoring coagulation function during perioperative period. Key words: Cardiac surgery; Cardiopulmonary bypass; Thromboelastography; Coagulation test