The platelet in cardiopulmonary bypass

Weerasinghe, Arjuna; Taylor, Kenneth M.

doi:10.1016/s0003-4975(98)00749-8

Cited by 169 publications

(128 citation statements)

References 67 publications

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“…Various studies have shown different results in the expression of the platelet receptors (CD41a, CD42b, and CD62P) with relation to different clinical settings during CPB (8,25,(31)(32)(33). Literature reviews report that various doses of methylprednisolone (1-30 mg/kg) have been used during CPB for the past 30 years.…”

Section: Discussionmentioning

confidence: 99%

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

Ebrahimi¹,

Kheirandish²,

Foroughi³

2016

Turk J Med Sci

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Background/aim: The purpose of this study was to examine steroid pretreatment in order to decrease postoperative coagulopathy disorders and bleeding. Materials and methods:In this randomized double-blinded study, the efficacy of low versus high doses of methylprednisolone on the coagulation system and postoperative bleeding was compared in patients who were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The platelet response to agonists, D-dimer concentration, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and platelet receptors CD42b, CD62P, and CD41a were evaluated. Results:The platelet response to agonists was reduced. The mean concentrations of D-dimer and tPA antigen increased although PAI-1 concentration did not show any significant changes following heparin neutralization. Postoperative expression of CD42b showed no changes in comparison with preoperation values in both groups. There was a significant increase in the expression of CD62P with a methylprednisolone dose of 15 mg/kg, while there was just a slight increase with a dose of 5 mg/kg. CD41a, as a fibrinogen receptor, was increased significantly after CPB in both groups. Significant data were shown in decreasing blood loss with a high dose of methylprednisolone. Conclusion:Methylprednisolone at a dose of 15 mg/kg reduced bleeding, probably by increasing CD62P after heparin neutralization, which can activate platelet activation in favor of better hemostasis.

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Section: Discussionmentioning

confidence: 99%

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

Ebrahimi¹,

Kheirandish²,

Foroughi³

2016

Turk J Med Sci

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“…Weerasinghe and Taylor [10] reported that constant contact was present between the shaped elements of the blood and the surface of the ECC during CPB as well as the continuous activation of factors and consumption of platelets by the blood sucked from the non-endothelial surgical field, all of which were important causes of morbidity and mortality in the cardiac surgery postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Phosphorylcholine-coated extracoporeal circulation systems affect coagulation factors during cardiopulmonary bypass insufficiently: a preliminary report

Çeviker¹

2014

Turk Gogus Kalp Dama

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“…For this reason, Wendel et al [18] in 1999, argued that high-dose Aprotinin may compete in the coating of the CPB circuit, making it more biocompatible and thus favoring the maintenance of platelet population and its viability in order to contribute to hemostasis after CPB. Moreover, the affinity of Aprotinin by proteins GPIIb/IIIa from the platelet receptor is cytoprotective, because it prevents the binding of platelets to foreign surfaces of the CPB circuit [19]. It is also known that Aprotinin reduces the binding of heparin on platelets.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, the platelet dysfunction induced by this anticoagulant is minimized by the drug [1] and can even be restored the ability of adhesion of the platelet that were rendered dysfunctional by heparin [20]. Due to reduction of platelet count in hypothermic CPB [19], one suspects, also, that the platelet-protective action of Aprotinin is more substantial [21] in this type of procedure, but it can also be functionally useful in preserving platelets even in normothermia [1].…”

Section: Discussionmentioning

confidence: 99%

Aprotinina preserva plaquetas em crianças com cardiopatia congênita acianogênica operadas com circulação extracorpórea?

Ferreira¹,

Vicente²,

Évora³

et al. 2009

Rev Bras Cir Cardiovasc

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Aprotinina preserva plaquetas em crianças com cardiopatia congênita acianogênica operadas com circulação extracorpórea?Does aprotinin preserve platelets in children with acyanogenic congenital heart disease undergone surgery with cardiopulmonary bypass? Abstract Objective: Evaluation of the hemostatic and platelets effects in children with acyanogenic congenital heart disease undergone on-pump surgery who received aprotinin.Methods: A prospective randomized study was performed on children aged 30 days to 4 years who had undergone correction of acyanogenic congenital heart disease using cardiopulmonary bypass (CPB) and were divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during CPB and the hemostatic dysfunction was analyzed by clinical and biochemical markers. Differences were considered to be significant when P<0.05.Results: The groups were similar regarding demographic and intraoperative variables, except for a greater hemodilution in the Aprotinin Group. The drug presented no benefit regarding time of mechanical pulmonary ventilation, stay in the postoperative intensive care unit and hospital, or regarding the use of inotropic drugs and renal function. Platelet concentration was preserved with the use of Aprotinin, whereas thrombocytopenia occurred in the Control Group since the initiation of CPB. Blood loss 5.

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The platelet in cardiopulmonary bypass

Cited by 169 publications

References 67 publications

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

The effect of methylprednisolone treatment on fibrinolysis, thecoagulation system, and blood loss in cardiac surgery

Phosphorylcholine-coated extracoporeal circulation systems affect coagulation factors during cardiopulmonary bypass insufficiently: a preliminary report

Aprotinina preserva plaquetas em crianças com cardiopatia congênita acianogênica operadas com circulação extracorpórea?

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