[HSF] aortic root replacement ,svere hyperbilirubinemia

[Hgrmd at aol.com]

Prasanna,
  For a routine Bentall I probably use 2 units FFP, 10-20 units of  cryo, and 
20 units of platelets.  If that takes care of the medical  bleeding, we're 
done.  If bleeding persists, then we give more platelets  and send off stat 
coags.  The amount of FFP I order depends on how many  units of packed cells have 
been given since the patient entered the room.   If none, no FFP.  If 2 or 
more, especially if the patient was on Coumadin  preop, I give 2 units.  I 
measure the fibrinogen and platelet count during  the pump run.  If fibrinogen less 
than 200, 10-20 units of cryo.  If  platelet count less than 120K, 10-20 units 
of platelets.  We still don't  use TEG as yet (I'm in the process of getting 
it.)  Hopefully, TEG will  help me refine my blood component needs.  I'll 
never have the low blood  bank utilization that you possess, but I'm working on it.
 
Hal



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