ABSTRACT
David Royston The rationale of any pharmacological intervention in cardiac surgical patients is to avoid the need for transfusion of blood or hemostatic products.
At-risk patient groups
Epidemiological studies in over 14000 patients have found that prolonged bypass time (>100 min but especially >150 min), increased age, creatinine greater than 200µ mol and procedures other than primary myocardial revascularization alone are risk factors for postoperative bleeding. Recent ingestion of platelet active agents, especially aspirin, has not been shown as a consistent risk factor for excessive bleeding in these recent series.
