Podcast
Questions and Answers
What was required to reduce bleeding and mortality during procedures?
What was required to reduce bleeding and mortality during procedures?
Which hemostatic powder required 2 to 3 times more to be effective?
Which hemostatic powder required 2 to 3 times more to be effective?
What was not tracked in the study regarding the two hemostatic powders?
What was not tracked in the study regarding the two hemostatic powders?
What factor is directly linked to increased postoperative bleeding?
What factor is directly linked to increased postoperative bleeding?
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In which plot type were the intra-operative platelets stratified?
In which plot type were the intra-operative platelets stratified?
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What is the primary objective of the clinical study?
What is the primary objective of the clinical study?
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Which statistical method was used to analyze the data collected in the study?
Which statistical method was used to analyze the data collected in the study?
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How many patients were involved in the retrospective analysis of the combination powder?
How many patients were involved in the retrospective analysis of the combination powder?
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What was one of the endpoints measured in this clinical study?
What was one of the endpoints measured in this clinical study?
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What types of cardiothoracic procedures were performed on the patients?
What types of cardiothoracic procedures were performed on the patients?
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What were the genders of the patients involved in the study?
What were the genders of the patients involved in the study?
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What is the name of the novel hemostatic agent being studied?
What is the name of the novel hemostatic agent being studied?
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What type of study design is used in the assessment of the hemostatic agents?
What type of study design is used in the assessment of the hemostatic agents?
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During which period was data for the polysaccharide starch powder collected?
During which period was data for the polysaccharide starch powder collected?
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Which hemostatic agent is made from porcine collagen?
Which hemostatic agent is made from porcine collagen?
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What is one of the enhancements provided by the CP hemostatic agent?
What is one of the enhancements provided by the CP hemostatic agent?
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What was the time frame for the CP group patients in this study?
What was the time frame for the CP group patients in this study?
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How many patients were included in the PP group for analysis?
How many patients were included in the PP group for analysis?
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Which group had surgeons in training involved in their procedures?
Which group had surgeons in training involved in their procedures?
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What surgical procedure type did both groups undergo?
What surgical procedure type did both groups undergo?
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Who were the surgeons performing the surgeries in the CP group?
Who were the surgeons performing the surgeries in the CP group?
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What was the primary aim of the study conducted by Bruckner et al.?
What was the primary aim of the study conducted by Bruckner et al.?
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What were the inclusion criteria mentioned for the study participants?
What were the inclusion criteria mentioned for the study participants?
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Which surgical approach was primarily used for the procedures in this study?
Which surgical approach was primarily used for the procedures in this study?
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What percentage of patients required unplanned emergent re-exploration for bleeding?
What percentage of patients required unplanned emergent re-exploration for bleeding?
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Which of the following was NOT listed as a morbidity in the study?
Which of the following was NOT listed as a morbidity in the study?
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What was the primary method for reversing heparinization after cardiopulmonary bypass?
What was the primary method for reversing heparinization after cardiopulmonary bypass?
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What medical condition was associated with renal failure as mentioned in the study?
What medical condition was associated with renal failure as mentioned in the study?
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What type of medical records were reviewed for the study?
What type of medical records were reviewed for the study?
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What was the observed reduction in chest tube output after 48 hours in mL?
What was the observed reduction in chest tube output after 48 hours in mL?
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What was the P-value for the reduction in packed red blood cell transfusions?
What was the P-value for the reduction in packed red blood cell transfusions?
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Which postoperative measurement did not show a significant difference between the CP and PP groups?
Which postoperative measurement did not show a significant difference between the CP and PP groups?
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What was the mean age of the CP group?
What was the mean age of the CP group?
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What was the estimated odds ratio for mortality within 30 days of surgery?
What was the estimated odds ratio for mortality within 30 days of surgery?
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Which factor was considered in the secondary analysis regarding blood loss and mortality?
Which factor was considered in the secondary analysis regarding blood loss and mortality?
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What statistical test was used to compare baseline demographics between the groups?
What statistical test was used to compare baseline demographics between the groups?
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What influence was observed regarding ICU days?
What influence was observed regarding ICU days?
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Study Notes
Safety and Efficacy of a Novel Thrombin Containing Hemostatic Powder
- A retrospective study compared a novel combination powder (CP) (HEMOBLAST™ Bellows) to an established polysaccharide starch powder (PP) (Arista™ AH) for hemostasis in cardiothoracic surgeries.
- CP contained porcine collagen, bovine chondroitin sulfate, and human pooled plasma thrombin.
- PP is a plant-derived, polysaccharide starch powder.
- The study included 162 patients undergoing 162 complex cardiothoracic surgeries like heart transplants, lung transplants, and ventricular assist device placements.
- The study compared blood loss, protamine to skin closure time, chest tube output, blood products, ICU stay, postoperative comorbidities, and 30-day mortality.
- CP demonstrated a reduction in chest tube output, packed red blood cell transfusions, fresh frozen plasma transfusions, and postoperative comorbidities compared to PP.
- However, there was no statistically significant difference in postoperative platelet transfusions, ICU stay, or 30-day mortality.
- The study design was observational, with data collected from a single institution over two periods.
- Study limitations include the observational nature of the study and the lack of detailed cost analysis for both modalities.
Procedure and Population
- Subjects were identified from the institution's practice, inpatient data, medical records, and electronic medical records.
- Inclusion criteria for patient recruitment were based on clinical practice for high-risk patients with high bleeding tendencies.
- Patients had to cease platelet inhibitors for at least 5 days and have corrected hypothrombocytopenia, anemia, and coagulopathy.
- Patients underwent cardiopulmonary bypass, except for 3 patients who required emergent re-exploration for bleeding within 24 hours.
Outcomes
- After adjusting for age, sex, and procedure type, no significant differences were found between the CP and PP groups in terms of age, sex, procedure type, postoperative platelet transfusions, ICU stay, and 30-day mortality.
- There was a statistically significant difference in chest tube output, packed red blood cell transfusions, fresh frozen plasma transfusions, and postoperative comorbidities.
- Secondary analysis suggested an association between total blood loss and 30-day mortality.
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Description
This quiz explores a retrospective study comparing a novel hemostatic powder to an established polysaccharide starch powder used in cardiothoracic surgeries. It examines aspects like blood loss, transfusions, and postoperative outcomes based on data from 162 patients. Test your understanding of the efficacy and safety of these hemostatic agents.
