Coagulation, fibrinolysis and bleeding after open-heart surgery
| Autor: | Gunvor Lilienberg, Lars Bagge, Sven-Olov Nyström, H. Tyden |
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| Rok vydání: | 1986 |
| Předmět: |
Male
Excessive Bleeding Extracorporeal Circulation medicine.medical_specialty medicine.medical_treatment Hemorrhage law.invention Von Willebrand factor law Fibrinolysis Cardiopulmonary bypass Humans Medicine Platelet Cardiac Surgical Procedures Blood Coagulation Aged biology Platelet Count business.industry Extracorporeal circulation Middle Aged Surgery Hematocrit Coagulation Anesthesia Hemostasis biology.protein Female Cardiomyopathies Cardiology and Cardiovascular Medicine business |
| Zdroj: | Scandinavian Journal of Thoracic and Cardiovascular Surgery. 20:151-160 |
| ISSN: | 0036-5580 |
| DOI: | 10.3109/14017438609106494 |
| Popis: | To investigate the disputed pathogenesis of excessive bleeding after open-heart surgery, variables representing different hemostatic systems were correlated to postoperative blood loss in 29 patients. The general bleeding tendency in the early postoperative phase was probably attributable to depletion of hemostatic agents due to hemodilution, decreased antiplasmin activity, instantaneous but reversible platelet dysfunction following protaminization, and the natural interval to development of complete hemostasis. Heavy bleeding (greater than 800 ml/16 h) occurred in ten patients, who had significantly reduced levels of von Willebrand factor and lower active platelet count than in eight patients with minor bleeding. Defective primary hemostasis thus seemed to be the main cause of increased postoperative bleeding in these patients. Determination of platelet function by glass retention test showed good clinical relevance and gave considerably more reliable diagnosis than conventional platelet count alone. The patient with the greatest blood loss also showed drastic decrease in the plasminogen-binding form of alpha 2-antiplasmin, suggesting that additionally impaired fibrinolysis inhibition may contribute to development of severe hemorrhagic complications. |
| Databáze: | OpenAIRE |
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