A prospective longitudinal study was performed. Haemoglobin level, fibrinogen level, platelet count and ROTEM parameters: clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF), 伪-angle (EXTEM, INTEM, FIBTEM) were measured before the procedure, at the end of cytoreductive surgery and after HIPEC. Appropriate statistical tests were used for comparison. A P<.05 was considered as significant.
Forty-one women, with median age 54 (range 34–76) were recruited. Cytoreductive surgery was followed by a reduction of haemoglobin level from 11.4±1.5 g/dl to 10.6±1.6 g/dl, a reduction of serum fibrinogen level from 269±69 mg/dl to 230±48 mg/dl (P<.01) and MCF decline from 20±10 to 16±8 mm (P<.01), in the FIBTEM test. HIPEC was followed by no hemostatic impairment. The number of packed red blood cells administered during patients stay kept a mild significant relationship with both fibrinogen level (蟻=−0.5, P=.002), and MCF EXTEM values (蟻=−0.43, P=.006), recorded after HIPEC.
The mild observed hemostatic impairment appeared after cytoreductive surgery instead of HIPEC, involving surgical haemorrhage as the most likely responsible factor. Further studies are required to confirm a correlation between transfusion needs and postoperative hemostatic tests.