Extensive hepatic surgery is often associated with coagulopathies. The thrombelastograph, a mechanical system that uses small (0.5 ml) whole blood samples, can detect hypercoagulability, plasma factor deficiencies, decreased platelet function, and fibrinolysis and heparin sodium effect. In 19 patients undergoing extensive hepatic surgery, five showed hypercoagulability prior to induction of anesthesia and four developed this condition during surgery. All instances of hypercoagulability were successfully treated with small doses (1,000 to 2,000 units) of heparin sodium.
Howland WS, Castro EB, Fortner JB, Gould P. Hypercoagulability: Thrombelastographic Monitoring During Extensive Hepatic Surgery. Arch Surg. 1974;108(4):605–608. doi:10.1001/archsurg.1974.01350280205034
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