Blood conservation with membrane oxygenators and dipyridamole
| Autor: | M. Mindy Madonik, Pui-Yuen Wong, Joan Ivanov, George T. Christakis, Arnold M. Benak, David S. Levitt, Paul A. Reilly, Kevin Teoh, Michael F.X. Glynn, Richard D. Weisel, A. Vickie Mee |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Pulmonary and Respiratory Medicine
Blood Platelets medicine.medical_specialty Membrane oxygenator Hemorrhage 6-Ketoprostaglandin F1 alpha Oxygenators Platelet Factor 4 law.invention Bubble oxygenator Hemoglobins Leukocyte Count Random Allocation Postoperative Complications law Internal medicine Cardiopulmonary bypass Medicine Humans Platelet Platelet activation Prospective Studies Coronary Artery Bypass Aged Oxygenators Membrane Clinical Trials as Topic business.industry Platelet Count Dipyridamole Middle Aged Thromboxane B2 Contraceptives Oral Combined medicine.anatomical_structure Blood Anesthesia Cardiology Surgery Cardiology and Cardiovascular Medicine business Platelet factor 4 Artery medicine.drug |
| Zdroj: | The Annals of thoracic surgery. 44(1) |
| ISSN: | 0003-4975 |
| Popis: | Cardiopulmonary bypass induces platelet activation and dysfunction, which result in platelet deposition and depletion. Reduced platelet numbers and abnormal platelet function may contribute to postoperative bleeding. A membrane oxygenator may preserve platelets and reduce bleeding more than a bubble oxygenator, and the antiplatelet agent dipyridamole may protect platelets intraoperatively and reduce bleeding postoperatively. A prospective randomized trial was performed in 44 patients undergoing elective coronary artery bypass grafting to assess the effects of the membrane oxygenator and dipyridamole on platelet counts, platelet activation products, and postoperative bleeding. Patients who were randomized to receive a bubble oxygenator and no dipyridamole had the lowest postoperative platelet counts, the greatest blood loss, and the most blood products transfused. Platelet counts were highest and blood loss was least in patients randomized to receive a membrane oxygenator and dipyridamole (p less than .05). A bubble oxygenator with dipyridamole and a membrane oxygenator without dipyridamole resulted in intermediate postoperative platelet counts and blood loss. Arterial thromboxane B2 and platelet factor 4 concentrations were elevated on cardiopulmonary bypass in all groups. Both the membrane oxygenator and dipyridamole were independently effective (by multivariate analysis) in preserving platelets. Optimal blood conservation was achieved with a membrane oxygenator and dipyridamole. |
| Databáze: | OpenAIRE |
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