The Use of Topical Hemostatic Agents in Cardiothoracic Surgery

Art Bracey; Aryeh Shander; Solomon Aronson; Bradley A Boucher; Domenico Calcaterra; Michael W A Chu; Richard Culbertson; Karim Jabr; Henrik Kehlet; Omar Lattouf; S Chris Malaisrie; C David Mazer; Martin M Oberhoffer; Sherri Ozawa; Theolyn Price; Todd Rosengart; Bruce D Spiess; Giuseppe Turchetti

doi:10.1016/j.athoracsur.2017.01.096

The Use of Topical Hemostatic Agents in Cardiothoracic Surgery

Ann Thorac Surg. 2017 Jul;104(1):353-360. doi: 10.1016/j.athoracsur.2017.01.096. Epub 2017 Apr 24.

Authors

Art Bracey¹, Aryeh Shander², Solomon Aronson³, Bradley A Boucher⁴, Domenico Calcaterra⁵, Michael W A Chu⁶, Richard Culbertson⁷, Karim Jabr⁸, Henrik Kehlet⁹, Omar Lattouf¹⁰, S Chris Malaisrie¹¹, C David Mazer¹², Martin M Oberhoffer¹³, Sherri Ozawa¹⁴, Theolyn Price¹⁵, Todd Rosengart¹⁶, Bruce D Spiess¹⁷, Giuseppe Turchetti¹⁸

Affiliations

¹ Department of Pathology, Baylor St. Luke's Hospital, Houston, Texas.
² Department of Anesthesiology, Critical Care and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey. Electronic address: aryeh.shander@ehmc.com.
³ Department of Anesthesiology, Duke University Hospital, Durham, North Carolina.
⁴ College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee.
⁵ Minneapolis Heart Institute and Hennepin County Medical Center, Minneapolis, Minnesota.
⁶ Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada.
⁷ Health Policy Systems Management, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
⁸ Cardiovascular Perfusion Services, Medical Center Navicent Health, Macon, Georgia.
⁹ Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
¹⁰ Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.
¹¹ Division of Cardiac Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
¹² Department of Anesthesia, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
¹³ Asklepios Klinik St. Georg, Hamburg, Germany.
¹⁴ Englewood Hospital and Medical Center, Englewood, New Jersey.
¹⁵ Penrose-St. Francis Health Services, Cardiac and Thoracic Surgery Associates, Colorado Springs, Colorado.
¹⁶ Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
¹⁷ Departments of Anesthesiology, Emergency Medicine and Biology, Virginia Commonwealth University Medical Center, Richmond, Virginia.
¹⁸ Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.

PMID: 28450136
DOI: 10.1016/j.athoracsur.2017.01.096

Abstract

Topical hemostatic agents are used in conjunction with conventional procedures to reduce blood loss. They are often used in cardiothoracic surgery, which is particularly prone to bleeding risks. Variation in their use exists because detailed policy and practice guidelines reflecting the current medical evidence have not been developed to promote best surgical practice in this setting. To address this need, the Society for the Advancement of Blood Management convened an International Hemostatic Expert Panel. This article reviews the available literature and sets out evidence-based recommendations for the use of topical hemostatic agents in cardiothoracic surgery.

Publication types

Review

MeSH terms

Administration, Topical
Blood Loss, Surgical / prevention & control*
Cardiac Surgical Procedures*
Hemostatic Techniques*
Hemostatics / administration & dosage*
Humans

Substances

Hemostatics