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There was no difference in microvascular bleeding in the RCT comparing platelet and FFP transfusions [ 25].
To date, there is no "gold standard" test for the assessment of microvascular bleeding in cardiac surgery.
A platelet count below 50 × 10.l−1 is strongly associated with haemostatic compromise and microvascular bleeding in a patient being treated for massive haemorrhage.
According to recommendations, FFP should be given to correct microvascular bleeding in the presence of coagulation test disorders or to correct microvascular bleeding during massive blood transfusion [ 29].
The pathogenesis of microvascular bleeding in cardiac surgery is multifactorial and may be related to changes in the hemostatic system associated with increased age, preoperative medication with platelet and/or coagulation inhibitors, and transient platelet dysfunction associated with cardiopulmonary bypass (CPB) [ 6- 12].
Similar(55)
We suggest that desmopressin be considered in refractory microvascular bleeding if the patient has been treated with platelet-inhibiting drugs such as acetylsalicylsalicylic acid (Grade 2C).
Generally, when visual inspection revealed microvascular bleeding or an important blood collection in the cardiotomy reservoir (generally 200 ml after weaning from CPB), the patient received an assessment of the haemostasis/coagulation profile through thromboelastography (TEG; Haemoscope, Niles, IL) with and without heparinase.
Replacing one blood volume or more without FFP results in dilutional coagulopathy, diffuse microvascular bleeding and increased mortality [ 40, 41].
(Grade 2C) If platelet dysfunction is documented in a patient with continued microvascular bleeding, we suggest treatment with platelet concentrates.
These articles discuss the causes of posttraumatic microvascular bleeding and the potential treatment options for controlling catastrophic hemorrhage in combat areas.
Referenced evidence for the usefulness of SLTs was found in only three prospective trials, investigating a total of 108 patients (whereby microvascular bleeding was a rare finding).
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