Postoperative bypass bleeding: a bypass-associated dilutional (BAD) coagulopathy?
Blood Cells Mol Dis
; 43(3): 256-9, 2009.
Article
en En
| MEDLINE
| ID: mdl-19699663
ABSTRACT
A number of associations with post-bypass bleeding have been described in the accompanying paper. Herein we hypothesize that dilution is an underlying cause through a malign series of bypass-associated events. Heparinized blood behaves anomalously when diluted. Clotting times first shorten somewhat, then--as the dilution of whole blood approaches 50%--rapidly lengthen to unclottability. During cardiopulmonary bypass, low blood volume patients are at a significant risk of clotting factor dilution which will always be more severe than the level of whole blood dilution. If severe enough, this dilution may lower plasma clotting factors to a critical level and may result in excess protamine administration, secondary to overestimation of heparin. The presence of un-neutralized protamine combined with critically lowered clotting factors leads to marked coagulopathy.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Trastornos de la Coagulación Sanguínea
/
Factores de Coagulación Sanguínea
/
Puente Cardiopulmonar
/
Hemorragia Posoperatoria
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Reacción a la Transfusión
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2009
Tipo del documento:
Article