Alterations in coagulation and fibrinolysis associated with cardiopulmonary bypass during open heart surgery

Tanaka, Kuniyoshi; Takao, Motoshi; Yada, Isao; Yuasa, Hiroshi; Kusagawa, M; Deguchi, Katsumi

doi:10.1016/s0888-6296(89)92642-2

Cited by 157 publications

(51 citation statements)

References 9 publications

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“…This patient 46 One also has to consider fibrinolysis, rather than fibrinogen levels less than 100 mg/dL, per se, as a causative factor of bleeding. 53 The present study demonstrated that factor V levels declined intraoperatively in excess of fibrinogen, other coagulation factors and platelets. Similarly, Harker and colleagues 4 found mean intraoperative factor V levels varied between 19% to 29%.…”

Section: Vol I'supporting

confidence: 54%

Changes in Blood Coagulation During and Following Cardiopulmonary Bypass:Lack of Correlation With Clinical Bleeding

et al. 1996

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Although previous studies have documented a wide variety of derangements in laboratory measurements of blood coagulation and platelets during cardiopulmonary bypass, limited data are available concerning the magnitude of these changes and any association with excessive bleeding.To determine whether abnormalities in commonly available laboratory tests for the evaluation of coagulation, fibrinolysis and hemostasis correlate with postoperative blood loss and transfusion requirements as measures of clinical outcome, 47 consecutive patients undergoing coronary artery bypass grafting with hypothermic cardiopulmonary bypass (CPB) were studied prospectively at 12 time points before, during, and following CPB. Routine blood coagulation tests, coagulation factor levels (fibrinogen, V, VII, VIII, and IX) and fibrinolysis (FDP) became abnormal within 15 minutes after patients were placed on CPB, remained abnormal for the duration of CPB, and recovered at varying rates after discontinuation of CPB. Mean factor V levels declined by the greatest percentage, to 15% of normal, followed by factor VIII which decreased to 30%. Platelet counts declined to below 100 X 10 9 /L after Diagnosing the cause of intra-or postoperative hemorrhage in patients undergoing cardiopulmonary bypass (CPB) is a difficult clinical problem. A number of alter- Supported in part by the Department of Veterans Affairs and Research Grant HL31035 from the National Heart, Lung, and Blood Institute, National Institutes of Health.Presented in part at the 36th Annual Meeting of the American Society of Hematology, Nashville, Tennessee, December 2-6, 1994 (Blood 199484[suppl l]:469a).Manuscript received October 27, 1995; revision accepted January 8, 1996.Address reprint requests to Dr. Levin: Department of Laboratory Medicine, VAMC (111H2), 4150 Clement Street, San Francisco, CA 94121. the initiation of CPB and remained low in the postoperative period. Twenty-eight percent of patients had mediastinal output a 100 mL per hour during the immediate postoperative period, and were considered to be "bleeders." There were no clinically relevant differences in any of the laboratory measurements between patients with normal postoperative blood loss and those defined as bleeders. Thus, the absence of significant correlations between various laboratory measurements of hemostasis and actual postoperative bleeding indicates that these laboratory derangements are transient, are not predictive of clinically important hemostatic abnormalities, and should not be used in isolation to guide the use of blood components in these patients. Furthermore, although bleeders received more blood components, there was surprisingly little effect on the coagulation factor levels measured.

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Section: Vol I'supporting

confidence: 54%

Changes in Blood Coagulation During and Following Cardiopulmonary Bypass:Lack of Correlation With Clinical Bleeding

et al. 1996

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“…[7]. Extracorporeal circulation and heparin may induce many abnormalities in the coagulation system, including thrombocytopenia [2], platelet dysfunction [8,9], coagulation factor deficiencies [10], residual heparin after protamine administration [11], and fibrinolysis [12]. Microvascular bleeding caused by dysfunctional platelets and an impaired coagulation cascade occur after CPB secondary to foreign surface contact [13].…”

Section: Resultsmentioning

confidence: 99%

Bleeding risk assessment using whole blood impedance aggregometry and rotational thromboelastometry in patients following cardiac surgery

Petričević

Biočina

Miličić

et al. 2013

J Thromb Thrombolysis

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“…Increased fibrinolysis during this period has been demonstrated by several other investigators. 16,23,[31][32][33][34][35] The usefulness of EACA to treat excessive bleeding after aortocoronary bypass was reported by Lambert in 1979. 36 Using the prothrombin time, partial thromboplastin time, fibrinogen level, and tri-F titer tests, hyperfibrinolytic bleeding was the most frequently identifiable coagulation disorder and was diagnosed in 20% of the patients.…”

Section: Eaca and Ta In Cardiac Surgerymentioning

confidence: 99%

Natural and synthetic antifibrinolytics in cardiac surgery

1992

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In an effort to reduce morbidity associated with transfusion of blood products, the use of antifibrinolytics to decrease bleeding and transfusions after cardiopulmonary bypass ( CPB) is receiving widespread attention. The predominant haemostatic defect induced by CPB and, therefore Afin de rdduire morbiditd associde aux transfusion sanguines, les anesthdsistes et les chirurgiens cardiaques utilisent de plus en plus les antifibrinolytiques darts le but de diminuer le saignement et les besoins transfusionnels secondaires it la circulation extracorporelle ( CEC). Les modifications de l 'hdmostase induites

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Alterations in coagulation and fibrinolysis associated with cardiopulmonary bypass during open heart surgery

Cited by 157 publications

References 9 publications

Changes in Blood Coagulation During and Following Cardiopulmonary Bypass:Lack of Correlation With Clinical Bleeding

Changes in Blood Coagulation During and Following Cardiopulmonary Bypass:Lack of Correlation With Clinical Bleeding

Bleeding risk assessment using whole blood impedance aggregometry and rotational thromboelastometry in patients following cardiac surgery

Natural and synthetic antifibrinolytics in cardiac surgery

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