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Icd decortication which blood should take before surgery

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preoperative testing thoracic surgery

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NICE routine preoperative tests full blood count clotting renal function surgery guideline

For thoracic decortication (usually for empyema), the preoperative blood work commonly includes:
  • CBC/FBC: hemoglobin, white cell count, platelet count
  • Blood group and screen, with crossmatch/reservation of packed red blood cells because bleeding can occur during decortication. The number of units is decided by the surgeon, anesthetist, hemoglobin level, and expected surgical complexity.
  • Coagulation profile: PT/INR, aPTT, and often fibrinogen if severe infection, liver disease, anticoagulant use, or bleeding risk
  • Kidney function and electrolytes: creatinine, urea, sodium, potassium
  • Liver function tests
  • Blood glucose, especially if diabetes or severe sepsis
  • ABG/VBG and lactate when respiratory compromise or sepsis is present
  • Infection-related tests as indicated: CRP, blood cultures before antibiotics if febrile or septic
If the patient takes warfarin, apixaban, rivaroxaban, heparin, aspirin, or clopidogrel, tell the surgical and anesthesia team early. The clotting and medication plan must be individualized. Routine coagulation testing is mainly indicated when there is suspected coagulopathy or relevant history, as anesthesia references emphasize.
You do not choose a specific blood type beforehand. The blood bank uses the patient’s ABO/Rh group and crossmatch to issue compatible blood. For emergencies, O-negative red cells may be used initially, according to hospital protocol.
Decortication is a major chest operation, so the final preoperative test list and crossmatched units should be ordered by the treating thoracic surgeon and anesthetist.

What blood tests are essential before decortication?

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preoperative laboratory testing surgery

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thoracic surgery decortication preoperative investigations blood group crossmatch CBC coagulation renal function

Before lung/pleural decortication, the essential blood tests are:
  1. Complete blood count (CBC/FBC)
    • Hemoglobin/hematocrit: checks for anemia
    • White blood cell count: helps assess infection
    • Platelet count: assesses bleeding risk
  2. Blood group, antibody screen, and crossmatch
    • Blood should be available if needed because decortication can involve significant bleeding.
  3. Coagulation profile
    • PT/INR
    • aPTT
    • Add fibrinogen if severe infection, liver disease, active bleeding, or suspected clotting problem.
    • Especially important if the patient uses anticoagulants or has liver disease.
  4. Renal function and electrolytes
    • Creatinine, urea, eGFR
    • Sodium, potassium, bicarbonate
      These affect anesthetic safety, fluid management, and antibiotic dosing.
  5. Liver function tests
    • Bilirubin, AST/ALT, albumin, often ALP
      Liver disease can affect clotting and drug handling.
Often added depending on the patient:
  • Blood glucose and HbA1c if diabetes is known or suspected
  • CRP and sometimes procalcitonin to follow empyema/infection
  • Blood cultures before antibiotics if fever, rigors, or suspected sepsis
  • Arterial blood gas and lactate if hypoxic, breathless, unstable, or septic
  • Infectious-disease screening according to local hospital policy
The decortication reference specifically lists CBC, coagulation profile, renal and liver tests, infection screening, and arranging crossmatched blood products preoperatively. StatPearls decortication review
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