Abstract
FIBTEM parameters might predict the amount of postoperative hemorrhage following total
knee arthroplasty (TKA), because fibrin polymerization and fibrinolysis have a central
role in postoperative hemorrhage following TKA. This study retrospectively evaluated
54 patients who had undergone unilateral primary TKA. Laboratory coagulation parameters,
including FIBTEM, were recorded before anesthesia induction and after admission to
the postanesthetic care unit. The decrease in hemoglobin (Hb), amount of hemorrhage
via closed suction drainage, fluid administration, and amount transfused were reviewed
postoperatively. The preoperative FIBTEM amplitudes 10 (A10) and 20 (A20) minutes
after clotting time and maximum clot firmness (MCF) had the highest correlations with
the postoperative decrease in Hb (p = 0.001, p = 0.002, and p = 0.003, respectively). The preoperative FIBTEM A10 <19 mm, A20 <20 mm, and MCF < 21 mm
predicted > 3.0 g/dL postoperative Hb decrement from the postanesthetic Hb value (p = 0.004, p = 0.007, and p = 0.012, respectively). Preoperative FIBTEM can predict the amount of postoperative
hemorrhage following TKA.
Keywords
patient blood management - FIBTEM - total knee arthroplasty
