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J Knee Surg 2018; 31(09): 889-894
DOI: 10.1055/s-0037-1620234
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preoperative FIBTEM Predicts Postoperative Hemorrhage in Total Knee Arthroplasty

Seong-Hyop Kim
1   Department of Anesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Republic of Korea
,
Chung-Sik Oh
1   Department of Anesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Republic of Korea
,
Tae-Hoon Kim
2   Department of Orthopedic Surgery, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Republic of Korea
,
Sewon Park
1   Department of Anesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Republic of Korea
,
Ka Young Rhee
1   Department of Anesthesiology and Pain Medicine, Konkuk University Medical Centre, Konkuk University School of Medicine, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

10 May 2017

07 December 2017

Publication Date:
03 January 2018 (online)

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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
 

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