Peroperatieve researchstudy with de ROTEM machine to hemostase of patients during aorta abdominalis aneurysm operation.

Background of the study:
Because nowadays it is common practice in bleeding patients first to infuse
crystalloid and colloid fluids before starting transfusion of blood or blood
products, a dilutional coagulopathy can easily develop. It is also common
practice to transfuse separate blood components instead of full blood.
Trasnfusion of blood components in the wrong ratio may easily maintain a
coagulopathy and hence contribute to blood loss. The classical coaguloation
tests such as the APTT, PT and INR measure after activation only the activity
of some of the coagulation factors present in the plasma, without paying any
attention to the contribution of cellular components of blood to the
coagulation. In these tests is only measured the number of seconds that it
takes before the coagulation is initiated. The propagation fase, the
polymerization of fibrinogen, the interaction between activated platelets and
fibrinogen, the quality of the formed clot and whether the fibrinolysis is
activated enough to break down the clot is completely overlooked by these
tests. Thromboelastography/thromboelastometry on the other hand, performed in
full blood including the cellular components measures the initiation phase, the
propagation phase, the quality of the formed clot and whether the formed clot
is broken down by the fibrinolysis.

Objective of the study:
Investigating with use of the classical coagulation tests on one hand and with
the ROTEM on the other hand what is exactly becoming disturbed in the
coagulaton because of bleeding during surgery of the aorta abdominalis,
measuring the effect on the coagulation of diluting the blood with different
infusion fluids, investigating the correlation between the classical
coagulation tests and the coagulation parameters measured with the ROTEM and
the correlation between the coagulation tests and perioperative blood loss.

Descriptive research on coagulation in patients during surgery of the aorta
abdominalis.

Not apply