Risk Factors Contributing To Blood Coagulation Dysfunction In Patients Undergoing Cardiac Surgery With Off-pump Coronary Artery Bypass Grafting

Objective:To screen the pre-and intraoperative risk factors for coagulopathy events during the perioperative period in adult patients undergoing off pump coronary artery bypass grafting.Methods:A total of 140 patients undergoing off pump coronary artery bypass grafting with intravenous anesthesia.Acrroding to the occurrence of coagulopathy events during intraoperative and postoperative 48 hours,they were divided into 2 groups:coagulopathy and non-coagulopathy groups.Each parameter of patient characteristics like sex,age,BMI,ASA grade,the number of years of surgery,the combined disease(hypertension and diabetes mellitus),the preoperative hematocrit(Hct),the left ejection fraction(LVEF),the arterial oxygen pressure(PaO2),liver function,operation time and intraoperative continuous cardiac output monitoring,positive end expiratory pressure,tranexamic acid,ulinastatin,hydroxyethyl starch infusion>20 ml/kg use,postoperative acidosis and hypothermia were recorded.Results:A total of 43 patients developed coagulopathy events,and the incidence was 31%.Compared with the normal group,the length of stay in the intensive care unit was longer and the total cost of hospitalization was higher(P<0.01).Univariate analysis showed that the two groups of patients were preoperative liver function,Hct,LVEF,operation time,intraoperative positive end expiratory pressure,continuous cardiac output monitoring,hydroxyethyl starch use,postoperative acidosis and low The difference of body temperature was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that surgeon has less annual surgery,abnormal liver function,pre-operative Hct,surgery time,continuous cardiac output monitoring,low body temperature after operation were independent risk factors for coagulopathy events.Conclusion:Patients with off-pump coronary artery bypass grafting have a higher incidence of coagulation dysfunction and affect the prognosis of patients,to strengthen the technical proficiency of the surgeon,more complete preoperative preparation,intraoperative blood transfusion,the use of continuous cardiac output Monitoring and postoperative prevention of hypothermia can reduce the incidence of coagulation dysfunction in patients undergoing off-pump coronary artery bypass grafting and improve the prognosis of patients.