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Haemostasis Disorders in Open Heart Surgery with Extracorporeal Circulation: Importance of the Platelet Function and the Heparin Neutralization
- Source :
- Vox Sanguinis. 32:41-51
- Publication Year :
- 1977
- Publisher :
- Wiley, 1977.
-
Abstract
- 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.
- Subjects :
- Blood Platelets
Extracorporeal Circulation
medicine.medical_specialty
Protamine sulfate
Platelet Aggregation
genetic structures
medicine.medical_treatment
Platelet Factor 4
Neutralization Tests
Fibrinolysis
medicine
Humans
Platelet
Cardiac Surgical Procedures
Hemostasis
biology
Heparin
business.industry
Extracorporeal circulation
Factor V
Hematology
General Medicine
Blood Coagulation Disorders
Protamine
Blood Coagulation Factors
Blood Cell Count
Surgery
stomatognathic diseases
Clotting time
Anesthesia
biology.protein
sense organs
business
medicine.drug
Subjects
Details
- ISSN :
- 14230410 and 00429007
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Vox Sanguinis
- Accession number :
- edsair.doi.dedup.....3606937f69679f2dfccc9c9c61f1b984