心臓手術の人工心肺復温時のトロンボエラストメトリー（ROTEM®），フィブリノゲン濃度，血小板数と輸血量，術後出血量との関連性についての検討

• Published in: Cardiovascular Anesthesia Vol. 19; no. 1; pp. 49 - 54
• Main Authors: 佐藤, 恒久, 川島, 信吾, 加藤, 孝澄, 木倉, 睦人, 高徳, 和宏, 平間, 大介, 西尾, 博臣, 佐藤, 重仁, 鈴木, 祐二, 青木, 隆之, 西澤, 純一郎
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本心臓血管麻酔学会 2015; Japanese Society of Cardiovascular Anesthesiologists
• Subjects: blood transfusion; cardiac surgery; fibrinogen; platelet; ROTEMTM
• ISSN: 1342-9132; 1884-7439
• DOI: 10.11478/jscva.2013-2-007

We measured thromboelastometry (ROTEMTM, A10: value of 10 minutes), fibrinogen concentration, and platelet counts during cardiopulmonary bypass. We estimated the necessity for blood transfusions from the end of cardiopulmonary bypass to 24 hours post-surgery in 51 patients undergoing adult cardiac surgery. The values that indicated the necessity for fresh frozen plasma were FIBTEM (A10) <6 mm and fibrinogen concentration<145 mg/dl. The values that indicated the necessity for platelet concentrates were platelet counts <80,000/μl and [EXTEM (A10)-FIBTEM (A10)] <30 mm. The results of this study indicate that, 1) FIBTEM (A10) estimates the necessity for fresh frozen plasma as well as fibrinogen concentration, 2) [EXTEM (A10)-FIBTEM (A10)] and platelet counts estimates the necessity for platelet concentrate, and 3) normalization of fibrinogen concentration >200 mg/dl or FIBTEM (A10) >10 mm and normalization of platelet counts >80,000/μl or [EXTEM (A10)-FIBTEM (A10)] >30 mm decreases the amount of post-operative bleeding by 30~50%. 本稿の内容の一部は，第 17 回日本心臓血管麻酔学会学術大会•総会（2012 年 9 月 15 日仙台市），藤田昌雄賞候補セッション，ポスターセッション（止血•凝固 2）にて発表し，藤田昌雄賞を受賞した。