Hemorrhage following cardiac surgery with cardiopulmonary bypass (CBP) is a major adverse event. Before the COVID-19 pandemic, an average of 288 000 cardiac surgeries were performed yearly in the United States.1 Despite medical advances and improved surgical techniques, CPB still poses risks to the patient. Cardiopulmonary bypass affects the clotting cascade through the loss of receptors for fibrinogen and von Willebrand factor, resulting in dilutional thrombocytopenia and decreased platelet activation.2 Consequently, the altered clotting cascade can lead to acute postoperative bleeding in cardiac surgery patients. For the acute care nurse practitioner (ACNP), it is essential to respond quickly and appropriately to coagulation deficits. The ACNP can use thromboelastography (TEG) to guide blood product administration in the clinical setting.3 Although much of the existing literature has established the benefits of using TEG in the treatment of trauma patients,4 very little clinical research is available that applies to...
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Summer 2023
Issues in Advanced Practice|
June 15 2023
Thromboelastography: A Novel Approach to Hemostasis in Cardiac Surgery
Cristina A. Wojack, DNP, RN, AGACNP-BC, CCRN;
Cristina A. Wojack, DNP, RN, AGACNP-BC, CCRN
Cristina A. Wojack is Nurse Practitioner, Cardiac Surgery Intensive Care Unit, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202 ([email protected]).
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Anna M. Marrocco, DNP, MSA, ACNP-BC;
Anna M. Marrocco, DNP, MSA, ACNP-BC
Anna M. Marrocco is Nurse Practitioner, Cardiac Surgery Intensive Care Unit, Henry Ford Health, and PhD student, Wayne State University, Detroit, Michigan.
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Jeanne Caitlyn Enstrom, DNP, AGACNP-BC;
Jeanne Caitlyn Enstrom, DNP, AGACNP-BC
Jeanne Caitlyn Enstrom is Instructor of Nursing, Vanderbilt University School of Nursing, and Nurse Practitioner, Cardiac Intensive Care Unit, Nashville, Tennessee.
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Jesus Casida, PhD, RN, APN-C, FAAN
Jesus Casida, PhD, RN, APN-C, FAAN
Department Editor
Jesus Casida is Endowed Professor and Executive Director, Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas.
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AACN Adv Crit Care (2023) 34 (2): 139–144.
Citation
Cristina A. Wojack, Anna M. Marrocco, Jeanne Caitlyn Enstrom, Jesus Casida; Thromboelastography: A Novel Approach to Hemostasis in Cardiac Surgery. AACN Adv Crit Care 15 June 2023; 34 (2): 139–144. doi: https://doi.org/10.4037/aacnacc2023957
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