Haemostatic profile of small children during and following cardiopulmonary bypass.
Jpn J Thorac Cardiovasc Surg
; 51(11): 577-81, 2003 Nov.
Article
em En
| MEDLINE
| ID: mdl-14650586
ABSTRACT
OBJECTIVE:
We evaluated changes of the haemostatic system during pediatric cardiac surgery during and after cardiopulmonary bypass (CPB).METHOD:
Twenty-five children under 15 kg of body weight undergoing open-heart surgery were divided into three groups; 9 patients (Group A), no bank blood was used throughout the surgery; 8 patients (Group B), packed red cells were used in the priming of CPB circuit; 8 patients (Group C) in cyanotic condition, for whom surgery was performed without bank blood. CPB caused a significant decrease of platelet counts in all three groups, the levels of which remained similar next morning.RESULTS:
Platelet counts decreased more significantly in Group C (59+/-27 k/mm3) than in Group A (119+/-42 k/mm3) and B (104+/-27 k/mm3). Platelet function-platelet activating factor test (HemoSTATUS) did not significantly decrease throughout the perioperative period in Group A. HemoSTATUS value decreased during CPB and recovered after CPB in Group B and C. Prothrombin time international ratio (PT-INR) and activated partial thromboplastin time were significantly prolonged just after CPB and recovered until next morning in all three groups. PT-INR was more prolonged in Group C (2.92+/-0.62) than in Group A (2.08+/-0.27) and B (2.42+/-0.42). There was no significant difference in postoperative bleeding for the first 12 hours among the three groups.CONCLUSION:
Although extreme hemodilution during CPB significantly impairs the coagulation and platelet system, these changes are usually transient and tolerable with minimal postoperative hemorrhage. However, a prolonged CPB and preoperative cyanotic condition may induce a critical decrease of platelet counts and increase postoperative bleeding.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Ponte Cardiopulmonar
/
Cardiopatias Congênitas
/
Hemostasia
Limite:
Humans
/
Infant
Idioma:
En
Revista:
Jpn J Thorac Cardiovasc Surg
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Japão