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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2014.1
- 수록면
- 224 - 231 (8page)
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Purpose: Hypothermia adversely affects the coagulation that could be of clinical significance in patients receiving clopidogrel. We evaluated the influence of hypothermia on transfusion requirements in patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) who continued clopidogrel use within 5 days of surgery. Materials and Methods: Protocol-based, prospectively entered data of 369 patients were retrospectively reviewed. The time-weighted average of intraoperative temperatures and the temperature upon ICU admission (TWA-temp) was assessed. Patients were divided into normothermia (≥36°C, n=224) and hypothermia (<36°C, n=145) group. The transfusion requirement for perioperative blood loss was assessed and compared. Results: Patients with hypothermia were older and had lower body surface area (BSA) than patients with normothermia. Age and BSA adjusted transfusion requirement was significantly larger in the hypothermia group [patients requiring transfusion: 64% versus 48%, p=0.003; number of units: 0 (0-2) units versus 2 (0-3) units, p=0.002]. In multivariate analysis of predictors of perioperative multiple transfusion requirements, hypothermia was identified as an independent risk factor along with age, female gender, BSA, chronic kidney disease, and congestive heart failure. Conclusion: Hypothermia was associated with increased transfusion requirement in patients undergoing OPCAB who received clopidogrel in proximity to surgery. Considering the high prevalence and the possibility of hypothermia being a modifiable risk factor, aggressive measures should be undertaken to maintain normothermia in those patients.
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참고문헌 (30)
참고문헌 신청
Valeri CR / 1992 / Effect of skin temperature on platelet function in patients undergoing extracorporeal bypass / J Thorac Cardiovasc Surg 104:108~116
Michelson AD / 1994 / Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro / Thromb Haemost 71:633~640
Martini WZ / 2005 / Independent contributions of hypothermia and acidosis to coagulopathy in swine / J Trauma 58:1002~1009
Romsi P / 2002 / Prolonged mild hypothermia after experimental hypothermic circulatory arrest in a chronic porcine model / J Thorac Cardiovasc Surg 123:724~734
Bjelland TW / 2010 / Antiplatelet effect of clopidogrel is reduced in patients treated with therapeutic hypothermia after cardiac arrest / Resuscitation 81:1627~1631
Michelson AD / 1994 / Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro / Thromb Haemost 71:633~640
Martini WZ / 2005 / Independent contributions of hypothermia and acidosis to coagulopathy in swine / J Trauma 58:1002~1009
Romsi P / 2002 / Prolonged mild hypothermia after experimental hypothermic circulatory arrest in a chronic porcine model / J Thorac Cardiovasc Surg 123:724~734
Bjelland TW / 2010 / Antiplatelet effect of clopidogrel is reduced in patients treated with therapeutic hypothermia after cardiac arrest / Resuscitation 81:1627~1631
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