Hematologic Changes During and Following Cardiopulmonary Bypass and Their Relationship to Non-Surgical Blood Loss. 1. Platelet Function and the Bleeding Time.

Fatores de risco de sangramento no pós-operatório de cirurgia cardíaca em pacientes adultos

“…Generally this was caused by low cardiac output either owing to cardiogenic shock or hypovolemia. Hypothermia has been implicated as a risk factor in other studies, [3,14], but it was not associated to the volume of blood loss in our series.…”

“…[1,3,[12][13][14] Coagulation disorders are normally linked to exposure of elements in the blood to the CPB circuit. It has been proved that CPB causes a reduction in the levels of coagulation factors, stimulates fibrinolysis, induces thrombocytopenia [14], disseminating intravascular coagulation and platelet dysfunction [15,16]. Also the effects of circulating heparin and protamine must be considered [17].…”

Un temps de céphaline activée élevé n’est pas associé à un rebond d’héparine après une chirurgie cardiaque

“…[25][26][27][28][29][30][31][32][33][34] Some have found a positive correlation between APTT and postoperative hemorrhage following cardiac surgery. 26,28,30,[35][36][37][38][39] Very few studies, in fact, have specified their transfusion algorithms for the management of hemorrhage, [26][27][28]40 thus making it difficult to ascertain how elevated APTT was interpreted and dealt with in most studies.…”

Reversible Hypothermia-Induced Inhibition of Human Platelet Activation in Whole Blood in Vitro and in Vivo

“…The hemorrhagic diathesis associated with hypothermic cardiopulmonary bypass surgery is considered to be primarily a platelet function defect (1,2,32). We have recently demonstrated that hypothermia correlates with both prolongation of the bleeding time and postoperative blood loss in patients undergoing cardiopulmonary bypass surgery (3,33). However, this clinical setting is complex because even during normothermic cardiopulmonary bypass surgery there is a platelet function defect (2).…”