In this episode of The Cardiac Recovery Room, moderator Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, spoke with Dr. Nadia Hensley, Associate Professor and Physician Advisor for Anesthesiology and Critical Care Medicine at John Hopkins School of Medicine; Dr. Nawwar Al-Attar, consultant cardiac surgeon at NHS Golden Jubilee National Hospital in Scotland; and Dr. Serdar Gunadyin, Head of Department at the University of Health Sciences in Turkey. The focus of their conversation was on surgical bleeding.

Chapters 

00:00 Intro 

02:35 Case 1, Diffuse Coagulopathy 

03:26 Bleeding Scale 

08:13 Team-Wide Bleeding Language 

11:07 Alternative Approaches 

14:09 Standardizing Test Results Response 

18:04 No Access to Visoelastic Testing 

19:55 Topical Hemostatic Agents 

23:08 Case 2 

24:14 Coagulopathy vs Surgical Bleeding 

28:08 Passive Hemostatic Agent 

29:10 Visoelastic Testing 

31:29 Closing Points

They discussed two different cases, including patient details and case specifics: one involving diffused coagulopathy and the other concerning focal bleeding. While examining these cases, they talked about hemostasis and the hemostasis checklist. They also discussed the validated intraoperative bleeding (VIBe) scale and its purposes, and the importance of being on the same page as your team. Additionally, they delved into viscoelastic testing and algorithms and addressed scenarios where access to viscoelastic testing may not be available. They also explored the thresholds for guided therapy, including functional fibrinogen levels. Lastly, the experts touched on passive hemostatic and how to teach residents coagulopathy and surgical bleeding.

The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.

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