Predictive Factors of Medical Bleeding in Adult Patients Undergoing Cardiac Surgery

Abstract

A percentage of post surgery bleedings thatleads to mediastinal reintervention do not havea surgical cause, and therefore the reinterventionwas not indicated. The objective of the studywas to determine predictive factors to recognizethe bleeding that does not require surgery.Methodology: retrospective study with 560patients, from whom 50 required reintervention forbleeding. The patients were divided in three groups: patients with not intervention, patients withreintervention and an anatomic lesion susceptibleof surgical reparation (surgical bleeding), andpatients with reintervention in whom a bleedingarea could not be identify. (medical bleeding).Results: Mortality and time of permanencein ICU was higher in the patients with medicalbleeding than in the other groups. Medicalbleeding was associated with long time ofextracorporeal circulation (p = 0,03), withcirculatory arrest of any duration (p <0,001) andwith surgery procedure category 3, according toHardy’s classification (p = 0,033). The use ofultrafiltartion techniques was statistically relatedwith a reduction in the medical bleeding.Conclusion: bleedings that need reinterventionafter surgery are related with a high increase inmortality and time of permanence in ICU. Patientsin whom a high risk of medical bleeding is predictedcan be benefited from the prophylactic use ofaprotinina or any other agent that help in thereduction of bleedings. It is clear that patients withmedical bleeding are worse of if they go to surgery.

Keywords

• Thoracic Surger
• postoperative hemorrhag
• extracorporeal circulatio
• disseminated intravascular coagulatio
• ultrafiltration