Alterations Of Hemostasis During Cardiopulmonary Bypass (CPB): A Comparison Between Membrane And Bubble Oxygenators

1981 ◽  
Author(s):  
R L Bick ◽  
N R Arbegast ◽  
W R Schmalhorst
Keyword(s):  
Cardiopulmonary Bypass ◽  
Platelet Function ◽  
Coronary Artery Bypass Surgery ◽  
Degradation Products ◽  
Artery Bypass ◽  
Membrane System ◽  
Platelet Dysfunction ◽  
Significant Correction ◽  
Function Defect ◽  
Membrane Oxygenators

Alterations of hemostasis during cardiopulmonary bypass (CPB) using bubble oxygenators have been previously defined and found to consist of a severe platelet function defect, a primary hyperfibrino(geno)lytic syndrome, and minimal thrombocytopenia. This study compares defects in hemostasis with membrane oxygenators and bubble oxygenators. 30 consecutive patients were studied and all patients studied were undergoing elective coronary artery bypass surgery. Tests of hemostasis included thrombin and reptilase times, protamine corrected thrombin times, soluble fibrin monomer, fibrinogen degradation products, fibrinolytic assays, platelet counts, and tests of platelet function. Studies were drawn pre-bypass, mid-bypass, and 1 hour post bypass. It was found that thrombocytopenia was much less in membrane patients. All patients developed a primary hyperfibrino(geno)lytic syndrome and the degree of this was equal in bubble or membrane oxygenators. Platelet dysfunction also was seen in all patients but was significantly different between the two oxygenation systems. At one hour postop, membrane patients showed no correction of platelet function as assessed by adhesion (14%), while those perfused with bubble oxygenators showed significant correction (67%) at one hour postop.In conclusion, the primary hyperfibrino(geno)lytic syndrome occurring during cardiopulmonary bypass appears to be of equal significance regardless of oxygenation mechanism. Less thrombocytopenia, but more platelet dysfunction is seen with the membrane system.

scholarly journals Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

2020 ◽  
Author(s):  
Khalid A. AlSaleh ◽  
Rashed B. AlBakr ◽  
Turki B. AlBacker ◽  
Rakan AlNazer ◽  
Abdulkareem Almomen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Platelet Function ◽  
Clinical Decision Making ◽  
Complete Blood Count ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Inverse Correlation ◽  
Platelet Dysfunction ◽  
Significant Difference

Abstract Background: Bleeding during coronary artery bypass surgery is a leading cause of mortality. Several factors have been associated with bleeding, platelet dysfunction being the most significant.Objective: to assess the effect of cardiopulmonary bypass machine (CPB) during cardiac surgery on platelet function using Platelet Function Analyzers (PFA-100), and Multiplate Electrode Aggregometry (MEA), and correlating that with a drop in Hemoglobin (Hb).Methods: Whole blood samples were collected preoperative and sixty minutes intraoperatively of different cardiac procedures utilizing (CPB) and tested for platelet function by PFA-100 and MEA. Complete blood count was measured using an automated hematology analyzer.Results: A significant difference was found between pre- and intraoperative ADP and EPI measurement in PFA-100, where preoperative PFA-ADP values displayed the ability to predict the intra-op drop in Hb (P–value 0.01, correlation coefficient 0.4699). At the same time, pre-op MEA- Ristocetin and TRAP showed an inverse correlation with an intra-op drop in Hb (-0.31 and -0.36). Conclusion: The current study reported significant changes in platelet dysfunction in cardiac surgeries with CPB, measured by two modalities PFA-100, and MEA. While PFA-100 and MEA both detected the changes in platelet dysfunction due to CPB, PFA-100 results were sensitive and positively predicted intra-op Hb drop as compared to MEA. There was a significant change in Hb one hour into the CPB, indicating that platelet transfusion might help decrease Intra- and postoperative bleeding independent of the platelet count as they are dysfunctional. PFA-100 results can be relied upon for distinction of high-risk cardiac surgery patients for bleeding and can be used for clinical decision making to improve patient outcome.

Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery

Perfusion ◽  
2010 ◽  
Vol 25 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Simo-Pekka Koivisto ◽  
Jan-Ola Wistbacka ◽  
Riikka Rimpiläinen ◽  
Juha Nissinen ◽  
Pertti Loponen ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
High Risk Patients ◽  
Risk Patients

A clinical evaluation of platelet function, haemolysis and oxygen transfer during cardiopulmonary bypass comparing the Quantum HF-6700 to the HF-5700 hollow fibre membrane oxygenator

Perfusion ◽  
2000 ◽  
Vol 15 (6) ◽  
pp. 479-484 ◽  
Author(s):  
A O Chukwuemeka ◽  
M RJ Turtle ◽  
U H Trivedi ◽  
G E Venn ◽  
D J Chambers
Keyword(s):  
Cardiopulmonary Bypass ◽  
Platelet Function ◽  
Clinical Evaluation ◽  
Oxygen Transfer ◽  
Artery Bypass ◽  
Membrane Surface ◽  
Platelet Activating Factor ◽  
Hollow Fibre ◽  
Priming Volume ◽  
First Time

The continued improvement of oxygenators is an important aspect of patient safety during cardiopulmonary bypass (CPB). The purpose of this study was to compare the Bard William Harvey HF-5700 oxygenator to the upgraded Bard Quantum HF-6700, which has recently been introduced into clinical practice. No clinical evaluation of this device has been published to date. The two oxygenators differ principally in that the Quantum has a smaller priming volume, achieved at the expense of a smaller membrane surface area which could result in sub-optimal gas exchange characteristics, increased haemolysis and increased platelet dysfunction during CPB. Twenty adult patients undergoing elective, first time coronary artery bypass grafting (CABG) were randomly assigned either to the HF-5700 ( n=10) or to the HF-6700 ( n=10) group. One patient underwent mitral valve repair in addition to CABG and was excluded from further study. There were no statistically significant differences in either preoperative or operative parameters between the two groups. Samples were obtained at the start of CPB, at 30 min, 60 min, at the end of CPB and at 1 h following termination of CPB. No significant differences between the two groups were found in oxygen transfer, haemolysis (plasma haptoglobin levels) or platelet function (a novel platelet activating factor (PAF)-induced platelet activation test) at any of the time points during CPB. It was concluded that the Quantum HF-6700 matches the HF-5700 for the parameters studied, whilst having the advantage of requiring a smaller priming volume.

Sign in / Sign up

Export Citation Format

Share Document