Factor XIII¿guided treatment algorithm reduces blood transfusion in burn surgery [Algoritmo de tratamento guiado pelo fator XIII reduz a transfusão sanguínea na cirurgia de queimados]

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Carneiro, JMGVDM (Author) Other; Alves, J (Author) Other; Conde, P (Author) Other; Xambre, F (Author) Other; Almeida, E (Author) Other; Marques, C (Author) Other; Luís, M (Author) Other; Godinho, AMMG (Author) Other; Fernandez¿Llimos, F (Author) Other

Journal

Title: Revista Brasileira de Anestesiologia

Vol. 68

Pages: 238-243

ISSN: 0034-7094

Publisher: Elsevier

Indexing

Scopus - 7 Citations

Other information

Authenticus ID: P-00R-P6B

DOI: 10.1016/j.bjan.2017.11.004

Abstract (EN): Background and objectives: Major burn surgery causes large hemorrhage and coagulation dysfunction. Treatment algorithms guided by ROTEM® and factor VIIa reduce the need for blood products, but there is no evidence regarding factor XIII. Factor XIII deficiency changes clot stability and decreases wound healing. This study evaluates the efficacy and safety of factor XIII correction and its repercussion on transfusion requirements in burn surgery. Methods: Randomized retrospective study with 40 patients undergoing surgery at the Burn Unit, allocated into Group A those with factor XIII assessment (n = 20), and Group B, those without assessment (n = 20). Erythrocyte transfusion was guided by a hemoglobin trigger of 10 g.dL¿1 and the other blood products by routine coagulation and ROTEM® tests. Analysis of blood product consumption included units of erythrocytes, fresh frozen plasma, platelets, and fibrinogen. The coagulation biomarker analysis compared the pre¿ and post¿operative values. Results and conclusions: Group A (with factor XIII study) and Group B had identical total body surface area burned. All patients in Group A had a preoperative factor XIII deficiency, whose correction significantly reduced units of erythrocyte concentrate transfusion (1.95 vs. 4.05, p = 0.001). Pre¿ and post¿operative coagulation biomarkers were similar between groups, revealing that routine coagulation tests did not identify factor XIII deficiency. There were no recorded thromboembolic events. Correction of factor XIII deficiency in burn surgery proved to be safe and effective for reducing perioperative transfusion of erythrocyte units. © 2017 Sociedade Brasileira de Anestesiologia

Language: English

Type (Professor's evaluation): Scientific