Abstract
BackgroundBleeding remains a potentially lethal complication of cardio-pulmonary bypass (CPB) surgery. The purpose of this study was to obtain a better insight into in vitro thrombin generation in the context of CPB.MethodsWe used Calibrated Automated Thrombography to assess blood coagulation of 10 low-risk patients operated for valve replacement with CPB, under 2 experimental conditions, one implicating platelets as platelet dysfunction has been described to occur during CPB.ResultsOur main finding was that CPB-induced coagulopathy was differently appreciated depending on the presence or absence of platelets: the decrease in thrombin generation was much less pronounced in their presence (mean endogenous thrombin potential change values before and after CPB were -3.9% in the presence of platelets and -39.6% in their absence).ConclusionOur results show that experimental conditions have a profound effect in the study of in vitro thrombin generation in the context of CPB.
Highlights
Bleeding remains a feared complication of cardiopulmonary bypass (CPB) surgery
We have reported in variant haemophiliacs that Calibrated Automated Thrombography (CAT), as an integrative in vitro phenotyping of coagulation, would be a better laboratory approach to assess the bleeding risk than the assays currently used in laboratory medicine [5]
Surgery was uneventful as indicated by the following parameters: cardio-pulmonary bypass (CPB) duration: 64 (48-118); cross clamp time: 52 (25-90); 24 h blood loss: 385 (170-750)
Summary
Bleeding remains a feared complication of cardiopulmonary bypass (CPB) surgery. We have reported in variant haemophiliacs that Calibrated Automated Thrombography (CAT), as an integrative in vitro phenotyping of coagulation, would be a better laboratory approach to assess the bleeding risk than the assays currently used in laboratory medicine [5]. Recent works have studied CAT thrombin generation in plasma of patients after CPB. Bleeding remains a potentially lethal complication of cardio-pulmonary bypass (CPB) surgery. The purpose of this study was to obtain a better insight into in vitro thrombin generation in the context of CPB. Methods: We used Calibrated Automated Thrombography to assess blood coagulation of 10 low-risk patients operated for valve replacement with CPB, under 2 experimental conditions, one implicating platelets as platelet dysfunction has been described to occur during CPB
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