Thrombocytopenia and Bleeding Tendency after Extracorporeal Circulation

The haemostatic defect following extracorporeal circulation

“…The process of heparin decay is retarded by hypothermia (Olsson, William-Olsson, and Lagergren, 1959). Despite this, we agree with the recommendation that supplemental doses are important (Senning, 1959;Fantl and Ward, 1960;Lillehei and others, 1960), and our current practice is to give an extra half a dose every 45 minutes after starting by-pass.…”

“…The elimination of heparin from the blood occurs more or less according to an exponential curve (Eiber and Danishefsky, 1958;Senning, 1959). During a by-pass procedure the decay of the heparin is probably slower because the heparin is in the body for only part of the time.…”

Platelet adhesion and consumption

“…Thrombocytopenia (a drop in the platelet count in the circulating blood) occurs during and after cardiopulmonary bypass, suggesting damage to the platelets during the passage through the pump oxygenator (Schmidt et al, 1961). However, it has become apparent that much less traumatising procedures also may induce thrombocytopenia.…”

Erfahrungen mit der frischen, autologen Bluttransfusion bei offener Herzchirurgie

“…Aus mehreren Arbeiten (2, 12, 20) ist bekannt, daß die Ursachen der nichtchirurgischen Blutung nach extrakorporaler Zirkulation neben der Abnahme von Plasmagerinnungsfaktoren auf der Traumatisierung der Thrombozyten beruht (15,23,27). Zur Vermeidung dieser Gerinnungsstörung bietet sich die Hämodilution und anschließende autologe Transfusion als optimale Lösung an.…”