Effect of cardiopulmonary bypass on hemostasis in patients undergoing cardiac surgery

Abstract

<p class="Abstract">This study aimed to evaluate the hemostatic derangement in patients undergoing elective cardiac surgery using cardiopulmonary bypass. Total 55 patients of either sex, were divided into three groups: Group A (n=20): Patients selected for elective cardiac surgery without cardiopulmonary bypass; Group B (n=20): Patients who undergone cardiac surgery with cardiopulmonary bypass time <90 min; and Group C (n=15): Patients who undergone cardiac surgery with cardiopulmonary bypass time either 90 min or more. The difference of mean hemoglobin, total count of WBC, and platelet count on immediate post-operative period and at 7 days after surgery were statistically significant among the groups. The mean hematocrit value, fibrinogen level and coagulation profile were statistically significant between the two groups in comparison to pre-operative value. The mean cross-clamp time and bypass time were statistically significant between the two sub-groups of cardiopulmonary bypass population. The mean blood loss was more (1513.3 ± 307.9 mL) where the cardiopulmonary bypass was used for >90 min in comparison to other population. Prolong cardiopulmonary bypass time associated with more hemostatic abnormalities and complications can be minimized by shortening the bypass time.</p>

Peri-operative outcomes of mitral valve surgery at Charlotte Maxeke Johannesburg Academic Hospital

“…(11)(12)(13) Prolonged cardiopulmonary bypass time (CPBT) was associated with haemostatic abnormalities. (7) CPBT >90 minutes resulted in higher mean blood losses peri-operatively. (7) Reoperation in mitral valve surgery was closely linked to prolonged CPBT.…”

“…(6) Platelets are activated and subsequently bind to the exposed subendothelium, the CPB circuit or to the circulating monocytes and neutrophils, resulting in a decrease in platelet numbers. (7) The decrease in platelet numbers and altered platelet function is the rationale behind the major blood loss encountered during cardiac surgery. (7,8) Multiple studies report that CPB has negative effects on haemostasis and the inflammatory response.…”

“…(7) The decrease in platelet numbers and altered platelet function is the rationale behind the major blood loss encountered during cardiac surgery. (7,8) Multiple studies report that CPB has negative effects on haemostasis and the inflammatory response. (7,9,10) The blood cell activation and plasma protein alteration that occurs during CPB increases bleeding time, post-operative blood loss and increases the risk for massive blood transfusion.…”

“…(7,8) Multiple studies report that CPB has negative effects on haemostasis and the inflammatory response. (7,9,10) The blood cell activation and plasma protein alteration that occurs during CPB increases bleeding time, post-operative blood loss and increases the risk for massive blood transfusion. (7) Bleeding occurs commonly in cardiac surgery and is a significant cause of morbidity and mortality.…”

“…(7,9,10) The blood cell activation and plasma protein alteration that occurs during CPB increases bleeding time, post-operative blood loss and increases the risk for massive blood transfusion. (7) Bleeding occurs commonly in cardiac surgery and is a significant cause of morbidity and mortality. (11) Two to eight percent of cardiac reoperations are indicated for uncontrolled bleeding.…”