Bleeding Management İn Open Heart Surgery

N/ANot Yet RecruitingNCT07366606

Serkan Uckun140 enrolled

Overview

This study aims to develop an algorithm that can guide targeted bleeding management through thromboelastography (TEG) viscoelastic testing performed on blood samples from patients undergoing open heart surgery. The goal is to develop an algorithm that supports targeted bleeding management based on TEG parameters. The study is prospective, in vitro, and non-invasive. The material will consist of residual blood samples from open heart surgery patients. Analyses will be performed using TEG parameters (R time, K time, MA, LY30). Patients will be randomized using a closed-envelope method and divided into two groups: anesthesiologist standard clinical observation-control (Group K) and anesthesiologist standard clinical observation and TEG analysis (Group T). The sample size is 70 patients per group. From an ethical standpoint, this study uses anonymous data without additional blood collection and ensures patient safety.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

140

Conditions

Thromboelastography (TEG)Open Heart Surgery Bleeding

Interventions

Blood ProductDIAGNOSTIC_TEST

R time, the time from the start of the test until the graph width reaches 2 mm (5-10 minutes), reflects the activity of clotting factors. K time, the time from the end of R until the width reaches 20 mm (1-3 minutes), represents the clot formation time and rate. alpha angle (53-72 degrees) represents fibrinogen function, maximum amplitude is related to platelet function (50-70 mm), represents maximum clot strength. lysis rate -30 (0% -8%) represents the clot lysis rate 30 minutes after MA, indicating whether hyperfibrinolysis is present.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 84 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who will undergo open heart surgery * Patients who have given informed consent Exclusion Criteria: * Patients undergoing emergency surgery * Patients with known congenital coagulation disorders * Patients with a known history of bleeding diathesis * Patients receiving uninterrupted anticoagulant therapy at an optimal time * Patients with renal failure under dialysis treatment * Patients with active malignancy * Patients who did not provide informed consent

Outcomes

Primary Outcomes

Targeted coagulation therapy

Measurement of R time using thromboelastography Measurement of K time using thromboelastography Measurement of maximum amplitude using thromboelastography

Time frame: A total of three measurements will be take After induction of anesthesia (Between 15 and 30 minutes of the operation) During cardiopulmonary bypass (2 hours after the start of surgery) Following cardiopulmonary bypass (4 hours after the start of surgery)

Secondary Outcomes

Use of blood products

Optimizing the use of fibrinogen, platelets, and fresh frozen plasma by combining thromboelastography measurements with clinical interpretation

Time frame: Anesthesia continues during cardiopulmonary bypass exit (4 to 5 hours after surgery)