Early recognition of surgically correctable causes of excessive mediastinal bleeding after coronary artery bypass graft surgery

American Journal of Surgery
E L MichelsonH MacVaugh

Abstract

In an attempt to establish criteria to enable recognition of patients with surgically correctable causes of excessive mediastinal bleeding, 250 patients undergoing coronary artery bypass graft surgery were reviewed. Ten (4 percent) required reexploration for excessive postoperative mediastinal bleeding and were compared with 95 consecutive control patients. There were no statistically significant differences in preoperative coagulation studies, use of aspirin or warfarin, number of vessels bypassed or bypass time. Mean mediastinal blood loss was statistically greater (p less than 0.001) in the reexploration group for the first 8 hours of the postoperative period than in the control group. Mean heterologous blood transfusion was 8.4 units in the reexploration group compared with 1.3 units in the control group. Based on analysis of the differences in mediastinal bleeding rates in the control and reexploration groups, we conclude that after coronary artery bypass graft surgery postoperative mediastinal bleeding of greater than 300 ml in the 1st hour, greater than 250 ml in the 2nd hours, and greater than 150 ml/hour thereafter suggests the presence of a surgically correctable lesion.

References

Sep 1, 1978·Annals of Internal Medicine·M TorosianH MacVaugh
Sep 1, 1976·Circulation·P W Majerus
Sep 11, 1975·The American Journal of Cardiology·J MeyerD A Cooley

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Citations

Sep 22, 2001·American Journal of Surgery·T Morikawa
Dec 1, 1996·The Annals of Thoracic Surgery·P de Moerloose
Oct 31, 2003·Clinical Imaging·Alberto AliprandiFrancesco Sardanelli
Mar 13, 2002·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·Timothy S HallAlan J Spotnitz
Dec 1, 1996·The Annals of Thoracic Surgery·G Hartstein, M Janssens
Aug 1, 1996·Journal of Cardiothoracic and Vascular Anesthesia·T L HigginsT Ryan
Jun 18, 2015·British Journal of Anaesthesia·S HastingsD McIlroy
Nov 1, 1984·The British Journal of Psychiatry : the Journal of Mental Science·C Bass

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