Evaluation of Coagulopathy in Acute Aortic Dissection
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Accession number;05A0625473
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| Title;Evaluation of Coagulopathy in Acute Aortic Dissection |
| Author;
TSUKAMOTO SAEKI
(Kokuritsubyoinkiko Saigaiiryose Shinzokekkangeka)
SHINDO SHOJI
(Kokuritsubyoinkiko Saigaiiryose Shinzokekkangeka)
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Journal Title;Japanese Journal of Intensive Care Medicine
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Journal Code:Z0581B
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ISSN:0389-1194
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VOL.29;NO.5;PAGE.381-388(2005)
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| Figure&Table&Reference;FIG.1, TBL.3, REF.17 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Bleeding is often difficult to control during surgery for acute aortic dissection. Coagulopathy caused by consumption of platelets and coagulation factors is a major contributing factor, as is the fragility of the aorta. Coagulopathy, as evidenced by platelet and fibrinogen values, tends to be worse in aged people, in open false lumen type aortic dissection, in Stanford type A acute aortic dissection, and in extensive aortic dissection (DeBakey type I or type III retrograde dissection). The dose of heparin should be titrated during cardiopulmonary bypass according to the preoperative fibrinogen level to avoid marked prolongation of activated clotting time. The fibrinogen level predicts the degree of consumption of coagulation factors, and helps to determine blood transfusion requirements and the need for fresh frozen plasma. To improve the outcome of acute type A operations, an accurate assessment of the degree of coagulopathy and of blood transfusion requirements is essential, in addition to highly developed surgical skills. (author abst.) |
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