Blood-Surface Interactions During Cardiopulmonary Bypass

Edmunds, L. Henry; Colman, Robert W.; Niewiarowski, Stefan

doi:10.1007/978-3-662-06119-0_4

Cited by 20 publications

(19 citation statements)

References 72 publications

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“…This finding is intuitive and a loss of intraoperative efficiency is an unavoidable part of resident training. This may be of concern, at least theoretically, given the potential risks and deleterious effects associated with perfusion support [8,20], including particulate microembolic [21], platelet and red blood cell effects, increased transfusion requirements [22], coagulation defects, immunosuppression [23], and systemic inflammatory response syndrome [24]. Fortunately, as demonstrated by Haan et al [8] the increased perfusion and bypass time associated with resident training does not compromise early outcomes.…”

Section: Discussionmentioning

confidence: 99%

Training surgeon status is not associated with an increased risk of early or late mortality after isolated aortic valve replacement surgery

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Training surgeon status is not associated with an increased risk of early or late mortality after isolated aortic valve replacement surgery

et al. 2014

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“…Contact of blood with the artificial surfaces of the extracorporeal circuit and tissue injury results in activation of platelets and both the extrinsic and intrinsic arms of the coagulation cascade (Edmunds, 1993;Rinder, 2000). Alterations to the hemostatic balance also occur through acute hemodilution from establishment of the extracorporeal circuit and blood volume expansion with colloids and saline (Abdelbaky and Atallah, 1994), consumption of coagulation factors and platelets (Despotis and Goodnough, 2000), and administration of pharmacological agents or blood products to manage bleeding or thrombosis during and after CPB surgery (Despotis et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Safety of Recombinant Human Factor XIII in a Cynomolgus Monkey Model of Extracorporeal Blood Circulation

Ponce¹,

Armstrong

Andrews

et al. 2005

Toxicol Pathol

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Factor XIII (FXIII) is a thrombin-activated plasma coagulation factor critical for blood clot stabilization and longevity. Administration of exogenous FXIII to replenish depleted stores after major surgery, including cardiopulmonary bypass, may reduce bleeding complications and transfusion requirements. Thus, a model of extracorporeal circulation (ECC) was developed in adult male cynomolgus monkeys (Macaca fascicularis) to evaluate the nonclinical safety of recombinant human FXIII (rFXIII). The hematological and coagulation profile in study animals during and after 2 h of ECC was similar to that reported for humans during and after cardiopulmonary bypass, including observations of anemia, thrombocytopenia, and activation of coagulation and platelets. Intravenous slow bolus injection of 300 U/kg (2.1 mg/kg) or 1000 U/kg (7 mg/kg) rFXIII after 2 h of ECC was well tolerated in study animals, and was associated with a dose-dependent increase in FXIII activity. No clinically significant effects in respiration, ECG, heart rate, blood pressure, body temperature, clinical chemistry, hematology (including platelet counts), or indicators of thrombosis (thrombin:antithrombin complex and D-Dimer) or platelet activation (platelet factor 4 and beta-thromboglobulin) were related to rFXIII administration. Specific examination of brain, heart, lung, liver, and kidney from rFXIII-treated animals provided no evidence of histopathological alterations suggestive of subclinical hemorrhage or thrombosis. Taken as a whole, the results demonstrate the ECC model suitably replicated the clinical presentation reported for humans during and after cardiopulmonary bypass surgery, and do not suggest significant concerns regarding use of rFXIII in replacement therapy after extracorporeal circulation.

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“…Bu farklılığın nedeni, KPB sırasında kanın nonendotelial yüzeye temas etmesi ve kan hücrelerinin duvarında sürtünmeye bağlı değişikliklerin oluşması (shear stres), uygun olmayan substratların salınmasına ve akımın non pulsatil olmasına bağlıdır. KPB, oluştur-duğu bu patofizyolojik değişiklikler nedeni ile sepsise benzetilmekte (17) ve neden olduğu bu sistemik inflamatuvar yanıt, postoperatif ciddi komplikasyonların gelişmesine neden olabilmektedir (18,19) . Kalp cerrahisi sonrası ilk 24 saat içinde kan volümünün ve plazma volümünün azaldığı bilinen bir gerçektir (20) .…”

Section: Kolloi̇d Solüsyonlarunclassified

Fluid and Electrolyte Therapy in Cardiac Surgery

Toraman¹

2013

GKDA Derg

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Blood-Surface Interactions During Cardiopulmonary Bypass

Cited by 20 publications

References 72 publications

Training surgeon status is not associated with an increased risk of early or late mortality after isolated aortic valve replacement surgery

Training surgeon status is not associated with an increased risk of early or late mortality after isolated aortic valve replacement surgery

Safety of Recombinant Human Factor XIII in a Cynomolgus Monkey Model of Extracorporeal Blood Circulation

Fluid and Electrolyte Therapy in Cardiac Surgery

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