| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1995;60:1008-1014
© 1995 The Society of Thoracic Surgeons
Department of Surgery, Brockton/West Roxbury Veterans Affairs Medical Center; Brigham and Women's Hospital; Harvard Medical School; and the Naval Blood Research Laboratory, Whitaker Cardiovascular Institute, and Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
Background. Platelet dysfunction and increased fibrinolysis are the most important etiologic factors in the hemostatic defect observed following the institution of cardiopulmonary bypass. This study examined the effects of heparin per se, administered before the institution of cardiopulmonary bypass, on platelet function and fibrinolysis.
Methods. Sampling was performed in 55 patients undergoing cardiac operations before and 5 minutes after the routine administration of heparin, before the institution of cardiopulmonary bypass.
Results. Heparin administration resulted in a significant prolongation of the bleeding time (from 6.3 ± 2.1 to 12.6 ± 4.9 minutes; p < 0.00001), a significant reduction in the level of shed blood thromboxane B2 (from 1,152 ± 669 to 538 ± 187 pg/0.1 mL; p = 0.00002), and an increase in the plasma levels of plasmin (from 11.8 ± 9.7 to 125.4 ± 34.8 U/L; p < 0.0001) and D-dimer (from 571.3 ± 297.1 to 698.5 ± 358.6 µg/mL; p = 0.05). There were no significant differences before and after heparin administration in the plasma levels of fibrinogen, plasminogen, tissue plasminogen activator, antiplasmin, antithrombin III, and von Willebrand factor.
Conclusions. Heparin, independent of cardiopulmonary bypass, causes both platelet dysfunction and increased fibrinolysis. The use of an alternative anticoagulant or a lower dose of heparin in conjunction with heparin-coated surfaces might improve the hemostatic balance during open heart operations.
Related Article
Ann. Thorac. Surg. 1995 60: 1014.
This article has been cited by other articles:
|
|
 |
|
  J. W. Hammon Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation Card. Surg. Adult, January 1, 2008; 3(2008): 370 - 389. [Full Text]
|
|
|
|
 |
|
 A. Ballotta, H. Z. Saleh, H. W. El Baghdady, M. Gomaa, F. Belloli, H. Kandil, Y. Balbaa, F. Bettini, E. Bossone, L. Menicanti, et al. Comparison of early platelet activation in patients undergoing on-pump versus off-pump coronary artery bypass surgery J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 132 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. B. Mossad, S. Machado, and J. Apostolakis Bleeding following deep hypothermia and circulatory arrest in children. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 34 - 46. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Kincaid Heparin during neonatal bypass. Perfusion, March 1, 2007; 22(2): 143 - 143. [PDF]
|
|
|
|
 |
|
 R. Taneja and D. C. Cheng Con: Heparin-Bonded Cardiopulmonary Bypass Circuits Should Be Routine for All Cardiac Surgical Procedures Anesth. Analg., December 1, 2006; 103(6): 1370 - 1372. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Pleym, V. Videm, A. Wahba, A. Asberg, T. Amundsen, L. Bjella, O. Dale, and R. Stenseth Heparin resistance and increased platelet activation in coronary surgery patients treated with enoxaparin preoperatively. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 933 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Williams and L. S. Ng'alla Heparin Therapy Leads to Platelet Activation and Prolongation of PFA-100 Closure Time Journal of Cardiovascular Pharmacology and Therapeutics, October 1, 2005; 10(4): 273 - 280. [Abstract] [PDF]
|
|
|
|
|
|
S. Tabata, S. Yamaguchi, H. Nagamine, S. Tomita, S. Arai, H. Takemura, and G. Watanabe Efficacy of FK633, an ultra-short acting glycoprotein IIb/IIIa antagonist on platelet preservation during and after cardiopulmonary bypass Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 289 - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F D Rubens and T Mesana The inflammatory response to cardiopulmonary bypass: a therapeutic overview Perfusion, January 1, 2004; 19(1_suppl): S5 - S12. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Albes, I. M. Stohr, M. Kaluza, A. Siegemund, D. Schmidt, R. Vollandt, and T. Wahlers Physiological coagulation can be maintained in extracorporeal circulation by means of shed blood separation and coating J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1504 - 1512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Ascione, M. Caputo, and G. D. Angelini Off-pump coronary artery bypass grafting: not a flash in the pan Ann. Thorac. Surg., January 1, 2003; 75(1): 306 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Edmunds Jr. and R. W. Colman Extracorporeal Circulation: Thrombosis and Bleeding Card. Surg. Adult, January 1, 2003; 2(2003): 338 - 348. [Full Text]
|
|
|
|
|
|
F. D. Rubens and T. Mesana Surface Modified Cardiopulmonary Bypass Circuits: Modifying the Inflammatory Response Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2002; 6(4): 301 - 306. [Abstract] [PDF]
|
|
|
|
|
|
R. Ascione, S. Al-Ruzzeh, K. Amer, and G. D Angelini Subsystem organ function during coronary surgery Perfusion, July 1, 2002; 17(4): 295 - 303. [Abstract] [PDF]
|
|
|
|
|
|
S. Samson and L. Shore-Lesserson Platelet Function and Cardiopulmonary Bypass Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 273 - 281. [Abstract] [PDF]
|
|
|
|
|
|
G. J. Despotis, M. S. Avidan, and C. W. Hogue Jr Mechanisms and attenuation of hemostatic activation during extracorporeal circulation Ann. Thorac. Surg., November 1, 2001; 72(5): S1821 - 1831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kottke-Marchant and S. Sapatnekar Hemostatic Abnormalities in Cardiopulmonary Bypass: Pathophysiologic and Transfusion Considerations Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 187 - 206. [Abstract] [PDF]
|
|
|
|
|
|
L. Shore-Lesserson Monitoring the Hematologic Complications of Cardiopulmonary Bypass Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 207 - 216. [Abstract] [PDF]
|
|
|
|
|
|
N. J. Skubas and G. J. Despotis Optimal Management of Bleeding Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 217 - 228. [Abstract] [PDF]
|
|
|
|
|
|
L.-C. Hsu Heparin-coated cardiopulmonary bypass circuits: current status Perfusion, September 1, 2001; 16(5): 417 - 428. [Abstract] [PDF]
|
|
|
|
|
|
M. J. Griffin, H. M. Rinder, B. R. Smith, J. B. Tracey, N. S. Kriz, C. K. Li, and C. S. Rinder The Effects of Heparin, Protamine, and Heparin/Protamine Reversal on Platelet Function Under Conditions of Arterial Shear Stress Anesth. Analg., July 1, 2001; 93(1): 20 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. R. Upchurch Jr, D. G. Goodman, S. R. Willoughby, Y.-Y. Zhang, G. N. Welch, J. E. Freedman, S. Ye, C. E. Costello, and J. Loscalzo Heparin Reacts With and Inactivates Nitric Oxide Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2001; 6(2): 163 - 173. [Abstract] [PDF]
|
|
|
|
|
|
R. Ascione, S. Williams, C. T. Lloyd, T. Sundaramoorthi, A. A. Pitsis, and G. D. Angelini Reduced postoperative blood loss and transfusion requirement after beating-heart coronary operations: A prospective randomized study J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 689 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ovrum, G. Tangen, R. Oystese, M. A. L. Ringdal, and R. Istad Comparison of two heparin-coated extracorporeal circuits with reduced systemic anticoagulation in routine coronary artery bypass operations J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0324 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H J Brinks, P W Weerwind, S Bogdan, H Verbruggen, and M H. Brouwer Does heparin pretreatment affect the haemostatic system during and after cardiopulmonary bypass? Perfusion, January 1, 2001; 16(1): 3 - 12. [Abstract] [PDF]
|
|
|
|
|
|
J.-O. Defraigne, J. Pincemail, G. Dekoster, R. Larbuisson, M. Dujardin, F. Blaffart, J.-L. David, and R. Limet SMA circuits reduce platelet consumption and platelet factor release during cardiac surgery Ann. Thorac. Surg., December 1, 2000; 70(6): 2075 - 2081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Despotis and L. T. Goodnough Management approaches to platelet-related microvascular bleeding in cardiothoracic surgery Ann. Thorac. Surg., August 1, 2000; 70(2): S20 - 32. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. W. Muriithi, P. R. Belcher, S. P. Day, V. C. Menys, and D. J. Wheatley Heparin-induced platelet dysfunction and cardiopulmonary bypass Ann. Thorac. Surg., June 1, 2000; 69(6): 1827 - 1832. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Huet, L. R. Salmi, D. Fergusson, A. W. M. M. Koopman-van Gemert, F. Rubens, and A. Laupacis A Meta-Analysis of the Effectiveness of Cell Salvage to Minimize Perioperative Allogeneic Blood Transfusion in Cardiac and Orthopedic Surgery Anesth. Analg., October 1, 1999; 89(4): 861 - 861. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Miyashita, Y. Hayashi, Y. Ohnishi, and M. Kuro Retrospective analysis of effect of low-dose aprotinin priming on allogeneic blood transfusion in repeated cardiac operations Perfusion, May 1, 1999; 14(3): 189 - 194. [Abstract] [PDF]
|
|
|
|
|
|
P. M. McCarthy, J.-P. P. Yared, R. C. Foster, D. A. Ogella, J. A. Borsh, and D. M. Cosgrove III A prospective randomized trial of Duraflo II heparin-coated circuits in cardiac reoperations Ann. Thorac. Surg., May 1, 1999; 67(5): 1268 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. D. Rubens, R. S. Labow, G. R. Lavallee, M. I. Watson, J. A. Robblee, M. E. Voorhees, and H. J. Nathan Hematologic evaluation of cardiopulmonary bypass circuits prepared with a novel block copolymer Ann. Thorac. Surg., March 1, 1999; 67(3): 689 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kawahito, E. Kobayashi, H. Iwasa, Y. Misawa, and K. Fuse Platelet aggregation during cardiopulmonary bypass evaluated by a laser light-scattering method Ann. Thorac. Surg., January 1, 1999; 67(1): 79 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Hyde, J. A Chinn, and T. R Graham Platelets and cardiopulmonary bypass Perfusion, December 1, 1998; 13(6): 389 - 407. [PDF]
|
|
|
|
|
|
C B. Mahoney Heparin-bonded circuits: clinical outcomes and costs Perfusion, May 1, 1998; 13(3): 192 - 204. [Abstract] [PDF]
|
|
|
|
|
|
T. B. Spanier, M. C. Oz, O. P. Minanov, R. Simantov, W. Kisiel, D. M. Stern, E. A. Rose, and A. M. Schmidt Heparinless cardiopulmonary bypass with active-site blocked factorIXa: A preliminary study on the dog J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1179 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. J. Gu, M. A. Mariani, W. van Oeveren, J. G. Grandjean, and P. W. Boonstra Reduction of the Inflammatory Response in Patients Undergoing Minimally Invasive Coronary Artery Bypass Grafting Ann. Thorac. Surg., February 1, 1998; 65(2): 420 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. J. Despotis, J. H. Joist, and L. T. Goodnough Monitoring of hemostasis in cardiac surgical patients: impact of point-of-care testing on blood loss and transfusion outcomes Clin. Chem., September 1, 1997; 43(9): 1684 - 1696. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Upchurch Jr, G. N. Welch, J. E. Freedman, A. J. Fabian, A. Pigazzi, A. M. Scribner, C. S. Alpert, J. F. Keaney Jr, and J. Loscalzo High-Dose Heparin Decreases Nitric Oxide Production by Cultured Bovine Endothelial Cells Circulation, April 15, 1997; 95(8): 2115 - 2121. [Abstract] [Full Text]
|
|
|
|
|
|
S. Bannan, A. Danby, D. Cowan, S. Ashraf, and P. G. Martin Low Heparinization With Heparin-Bonded Bypass Circuits: Is It a Safe Strategy? Ann. Thorac. Surg., March 1, 1997; 63(3): 663 - 668. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Hiramatsu, N. Gikakis, H. L. Anderson III, J. H. Gorman III, C. Marcinkiewicz, R. J. Gould, S. Niewiarowski, and L. H. Edmunds Jr. TIROFIBAN PROVIDES ""PLATELET ANESTHESIA"" DURING CARDIOPULMONARY BYPASS IN BABOONS J. Thorac. Cardiovasc. Surg., January 1, 1997; 113(1): 182 - 193. [Abstract] [Full Text]
|
|
|
|
|
|
E. Ovrum, E. A. Holen, G. Tangen, and M.-A. L. Ringdal Heparinized Cardiopulmonary Bypass and Full Heparin Dose Marginally Improve Clinical Performance Ann. Thorac. Surg., October 1, 1996; 62(4): 1128 - 1133. [Abstract] [Full Text]
|
|
|
|
|
|
G. S. Aldea, M. Doursounian, P. O'Gara, P. Treanor, O. M. Shapira, H. L. Lazar, and R. J. Shemin Heparin-Bonded Circuits With a Reduced Anticoagulation Protocol in Primary CABG: A Prospective, Randomized Study Ann. Thorac. Surg., August 1, 1996; 62(2): 410 - 418. [Abstract] [Full Text]
|
|
|
|
|
|
A. Wahba, G. Rothe, G. Schmitz, D. E. Birnbaum, S. F. Khuri, C. R. Valeri, J. Loscalzo, and A. D. Michelson Heparin Effect on Platelets and Fibrinolysis Ann. Thorac. Surg., May 1, 1996; 61(5): 1590 - 1591. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
