Article
Changes of coagulation parameters during surgery of meningiomas
Änderung der Gerinnungsparameter während der operativen Versorgung intrazerebraler Meningeome
Search Medline for
Authors
Published: | May 4, 2005 |
---|
Outline
Text
Objective
Surgery of meningiomas has been reported to be associated with changes of the coagulation system. An increase of D-dimers has been described and was associated with an increased risk for thromboembolism. Aim of the current study was to investigate changes of the coagulation parameters with regard to intraoperative blood loss.
Methods
In this prospective study, the measurement of D-dimers, fibrinogen and AT III was added to the routine pre-, intra- and postoperative evaluation of standard coagulation parameters (PTT and aPTT) in patients undergoing surgical removal of intracranial meningiomas. Hemoglobin, platelets, coagulation parameters, tumor volume and duration of surgery were correlated to the intraoperative blood loss.
Results
Data were available for 52 patients undergoing surgical removal of intracranial meningiomas. Mean (SD) age of the patients was 56(14) years. Median tumor volume was 67cm3. Mean blood loss during surgery was 742± 858ml (range 50 – 5500ml). Hb decreased from 14.1± to 10.1 until the end of surgery. Median D-dimer (µl/ml) increased from 0.3 before surgery to 2.1 intraoperatively and to 2.5 postoperatively. Fibrinogen levels (mg/dl) were 291 and decreased to 157 during surgery, AT III from 109% to 78%. Preoperative and intraoperative coagulation parameters revealed only weak correlation to the amount of total blood loss with aPTT showing the highest correlation (r=0.6, p<0.01).
Conclusions
Our preliminary evaluation show that routine preoperative coagulation parameters do not correlate with intraoperative blood loss. Additional measurement of D-dimer, fibrinogen and AT III before and during surgery yield no further information on disturbances of hemostasis neither before nor during surgery.