| Title |
Point-of-care viscoelastic hemostatic testing in cardiac surgery patients: a systematic review and meta-analysis
|
|---|---|
| Published in |
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, September 2018
|
| DOI | 10.1007/s12630-018-1217-9 |
| Pubmed ID | |
| Authors |
Carly Lodewyks, Jeffrey Heinrichs, Hilary P. Grocott, Keyvan Karkouti, Grace Romund, Rakesh C. Arora, Navdeep Tangri, Rasheda Rabbani, Ahmed Abou-Setta, Ryan Zarychanski |
| Abstract |
Thromboelastography and rotational thromboelastometry are point-of-care (POC) viscoelastic tests used to help guide blood product administration. It is unclear whether these tests improve clinical or transfusion-related outcomes. The objective of this study was to appraise data from randomized trials evaluating the benefit of POC testing in cardiac surgery patients. Primary outcomes were the proportion of patients transfused with blood products and all-cause mortality. Medline (Ovid), EMBASE (Ovid), CENTRAL (the Cochrane Library-Wiley), Web of Science, Biosis, Scopus, and CINAHL databases, as well as clinical trial registries and conference proceedings were queried from inception to February 2018. We identified 1,917 records, 11 of which were included in our analysis (8,294 patients). Point-of-care testing was not associated with a difference in the proportion of patients transfused with any blood product (risk ratio [RR], 0.90; 95% confidence interval [CI], 0.79 to 1.02; I2 = 51%; four trials, 7,623 patients), or all-cause mortality (RR, 0.73; 95% CI, 0.47 to 1.13; I2 = 5%; six trials, 7,931 patients). Nevertheless, POC testing was weakly associated with a decrease in the proportion of patients receiving red blood cells (RBC) (RR, 0.91; 95% CI, 0.85 to 0.96; I2 = 0%; seven trials, 8,029 patients), and heterogeneous reductions in frozen plasma (FP) (RR, 0.58; 95% CI, 0.34 to 0.99; I2 = 87%; six trials, 7,989 patients) and platelets (RR, 0.66; 95% CI, 0.49 to 0.90; I2 = 65%; seven trials, 8,029 patients). Meta-analysis of the number of units of RBCs and FP was not possible due to heterogeneity in reporting, however POC testing significantly reduced the units of platelets transfused (standard mean difference, -0.09; 95% CI, -0.18 to 0.00; four trials, 7,643 patients). Our review indicates that in cardiac surgery patients, POC viscoelastic hemostatic testing is not associated with a reduction in the proportion of patients receiving any blood product or all-cause mortality. However, viscoelastic testing is weakly associated with a reduction in proportion of patients transfused with specific blood products. Presently, the benefits associated with viscoelastic testing in cardiac surgery patients are insufficiently robust to recommend routine implementation of this technology. PROSPERO (CRD4201706577). Registered 11 May 2017. |
X Demographics
The data shown below were collected from the profiles of 21 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 7 | 33% |
| Spain | 6 | 29% |
| Turkey | 1 | 5% |
| Malaysia | 1 | 5% |
| France | 1 | 5% |
| United Kingdom | 1 | 5% |
| Finland | 1 | 5% |
| Unknown | 3 | 14% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 14 | 67% |
| Scientists | 4 | 19% |
| Science communicators (journalists, bloggers, editors) | 2 | 10% |
| Practitioners (doctors, other healthcare professionals) | 1 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 12% |
| Researcher | 4 | 9% |
| Student > Postgraduate | 4 | 9% |
| Professor > Associate Professor | 4 | 9% |
| Student > Master | 3 | 7% |
| Other | 11 | 26% |
| Unknown | 12 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 60% |
| Nursing and Health Professions | 2 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Environmental Science | 1 | 2% |
| Agricultural and Biological Sciences | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 11 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 April 2019.
All research outputs
#3,602,568
of 25,385,509 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#585
of 2,879 outputs
Outputs of similar age
#68,990
of 346,007 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#10
of 35 outputs
Altmetric has tracked 25,385,509 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,879 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has done well, scoring higher than 79% of its peers.
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We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.