Postoperative blood loss after extracorporeal circulation for heart valve surgery

Garcia, JoséA B.; Pakrashi, Brojesh C.; Mary, David A.S.G.; Tandon, Rajendra; Ionescu, Marian I.

doi:10.1016/s0022-5223(19)40784-8

Cited by 18 publications

(1 citation statement)

References 22 publications

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“…As many authors [7, 11, 23, 24, 32, 34, 38, 41, 44, 46, 47, 49, 55, 57, 65, process. Indeed, on the one hand, the platelet decrease observed does not correspond to the hemodilution (1 vol blood and 2 vol tliluent) realized in the extracorporeal circuit, and on the other hand there are some parameters like normal amount of factor VIII, absence of FDP in serum, decrease of platelet plasmin inhibitor, which exclude it process of disseminated intravascular coagulation supported by some authors [7, 9, IS, 20,23,32,36,44,56,65,71,77,801.…”

Section: Discussionmentioning

confidence: 92%

Hæmostasis Disorders in Open Heart Surgery with Extracorporeal Circulation: Importance of the Platelet Function and the Heparin Neutralization

Moriau¹,

Masure²,

Hurlet³

et al. 1977

Vox Sanguinis

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The main haemostasis changes observed in a screening study performed in 40 patients who underwent an open heart surgery with extracorporeal circulation (ECC) are: a significant drop in platelet count from the onset of the ECC to the third postoperative day, a decrease of platelet retention and aggregation during ECC with an 8-day persistently increased heparin-neutralizing activity in plasma but not in serum, a moderate decrease of plasma factors I, II, VII-X, X and XIII and a more important drop in factor V which disappears 24 h after ECC, a transitory increase of fibrinolysis during ECC and the lack of FDP elevation in the serum. These disorders require a very good neutralization of the heparin used during ECC. The ratio protamine/heparin can be established by a titration clotting time test. Protamine chloride seems to be more efficacious and to act more quickly than protamine sulfate for the neutralization. An overload in protamine can enhance the hemostatic, biological and clinical disorders. The preventive administration of platelet concentrate immediately after the heparin neutralization contributes to reduce the bleeding disorders related to the quantitative and qualitative platelet defects.

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Section: Discussionmentioning

confidence: 92%

Hæmostasis Disorders in Open Heart Surgery with Extracorporeal Circulation: Importance of the Platelet Function and the Heparin Neutralization

Moriau¹,

Masure²,

Hurlet³

et al. 1977

Vox Sanguinis

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Control of Bleeding in Patients With Immune and Nonimmune Thrombocytopenia With Aminocaproic Acid

Bartholomew

Salgia²,

Bell³

1989

Arch Intern Med

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The effect of Premarin on blood loss attending open heart surgery

Mary

Abid

Pohlner

et al. 1976

Journal of British Surgery

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Premarin was administered prophylactically to every other patient in a series of 148 consecutive cases of open intracardiac surgery. Of these, 132 patients were matched to analyse the results of Premarin administration and postoperative blood loss. There were 67 patients who were given Premarin and 65 who did not receive this drug; both groups were identical in respect of age and sex. Matching was undertaken according to history of previous cardiac operations and anticoagulation, type of valve surgery or repair of congenital anomaly, duration of perfusion, platelet count and the use of fresh blood and epsilon-aminocaproic acid in the postoperative period. The prophylactic use of Premarin was not associated with a reduction in postoperative bleeding.

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Postoperative blood loss after extracorporeal circulation for heart valve surgery

Cited by 18 publications

References 22 publications

Hæmostasis Disorders in Open Heart Surgery with Extracorporeal Circulation: Importance of the Platelet Function and the Heparin Neutralization

Hæmostasis Disorders in Open Heart Surgery with Extracorporeal Circulation: Importance of the Platelet Function and the Heparin Neutralization

Control of Bleeding in Patients With Immune and Nonimmune Thrombocytopenia With Aminocaproic Acid

The effect of Premarin on blood loss attending open heart surgery

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