Mumps Epididymo-orchitis and its Treatment with Cortisone

Abstract

EXTRACORPOREAL CIRCULATION MEDICALJOSHRNAL Summary and Conclusions A small series of patients undergoing open cardiac surgery utilizing an extracorporeal circulation was investigated to demonstrate the effect of perfusion on certain cellular components and coagulation factors of the blood.Thrombocytopenia occurred in 12 of the 13 cases and persisted for at least 24 hours. A neutrophil leucocytosis occurred during perfusion, but the count tended to fall to previous levels by the end of the operation. There was a lymphopenia and eosinopenia.A fall in plasma fibrinogen followed perfusion in 10 of the 13 cases, and there was increased fibrinolysis in five. A constant decrease in plasma fibriniolytic activity was present on the day after operation. The possible significance of this unexpected finding is discussed.The use of the plasma thrombin time to demonstrate residual heparin activity after protamine neutralization is described, and this was present in six of the seven cases investigated. The other case possibly developed a circulating anticoagulant other than heparin. No tendency to bleed developed in these cases, but the investigation of coagulation factors was rendered difficult by the presence of heparin.Changes in coagulation factors were investigated in seven cases. One-stage prothrombin times (factor V and factor VII) and serum thromboplastin generation tests (Christmas factor) were not significantly affected by perfusion even in the presence of traces of heparin. Prothrombin activity as measured by the two-stage method was more sensitive to heparin but was not grossly altered in four cases. In two other cases there was a decrease in prothrombin activity on the day after operation. Antihaemophilic globulin levels were variable, being decreased after operation in two cases and increased in three.No correlation was found between any of the haematological changes and the duration and rate of perfusion. Excess bleeding or purpuric manifestations were not encountered in any patient.