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Ann Thorac Surg 1984;37:233-238
© 1984 The Society of Thoracic Surgeons
From the Departments of Anesthesiology, University of Pennsylvania, Philadelphia, PA, Deborah Heart and Lung Center, Browns Mills, NJ, and South Miami Hospital, South Miami, FL
Accepted for publication July 6, 1983.
* Address reprint requests to Dr. Moore, Deborah Heart and Lung Center, Browns Mills, NJ 08015
The effect of hypothermic cardiopulmonary bypass (CPB) was studied in 5 patients with strongly positive cold agglutination at 4°C (experimental group) and in 10 controls. In the in vitro part of the study, the characteristics of the cold agglutinin antibodies in the experimental group included a low thermal amplitude (28°C or less), a low 4°C agglutination titer (1:32 or less), and non-specificity (non-anti-I and non-anti-i). The in vivo portion of the study revealed a fall in total urine and serum free hemoglobin in both groups on going on bypass, followed by a rise for the remainder of bypass. Statistical comparison between observed and expected total free hemoglobin for both groups showed a significant rise (p < 0.05) after bypass, thereby indicating ongoing hemolysis. No statistically significant difference between preoperative and postoperative blood urea nitrogen and creatinine levels and gross neurological status was observed in the experimental group.
It was concluded that the patient with nonspecific cold agglutinins whose antibody is characterized by a low titer, a low thermal amplitude, and a lack of clinical symptomatology can undergo hypothermic CPB without increased threat of a hemolytic or vascular occlusive crisis.
This article has been cited by other articles:
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S. K Dove, S. A Raskin, and D S. Lawson Review articles: Cold agglutinins and hypothermic cardiopulmonary bypass Perfusion, January 1, 1992; 7(1): 3 - 6. [Abstract] [PDF]
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