Haemostatic Profile of Small Children during and following Cardiopulmonary Bypass

Fumio Fukumura, Akira Sese, Yasutaka Ueno, Yutaka Imoto, Masato Sakamoto, Yoshihisa Tanoue, Hiromichi Sonoda

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: We evaluated changes of the haemostatic system during pediatric cardiac surgery during and after cardiopulmonary bypass (CPB). Method: Twenty-five children under 15 kg of body weight undergoing open-heart surgery were divided into three groups; 9 patients (Group A), no bank blood was used throughout the surgery; 8 patients (Group B), packed red cells were used in the priming of CPB circuit; 8 patients (Group C) in cyanotic condition, for whom surgery was performed without bank blood. CPB caused a significant decrease of platelet counts in all three groups, the levels of which remained similar next morning. Results: Platelet counts decreased more significantly in Group C (59±27 k/mm3) than in Group A (119±42 k/mm 3) and B (104±27 k/mm3). Platelet function-platelet activating factor test (HemoSTATUS™) did not significantly decrease throughout the perioperative period in Group A. HemoSTATUS™ value decreased during CPB and recovered after CPB in Group B and C. Prothrombin time international ratio (PT-INR) and activated partial thromboplastin time were significantly prolonged just after CPB and recovered until next morning in all three groups. PT-INR was more prolonged in Group C (2.92±0.62) than in Group A (2.08±0.27) and B (2.42±0.42). There was no significant difference in postoperative bleeding for the first 12 hours among the three groups. Conclusion: Although extreme hemodilution during CPB significantly impairs the coagulation and platelet system, these changes are usually transient and tolerable with minimal postoperative hemorrhage. However, a prolonged CPB and preoperative cyanotic condition may induce a critical decrease of platelet counts and increase postoperative bleeding.

Original languageEnglish
Pages (from-to)577-581
Number of pages5
JournalJapanese Journal of Thoracic and Cardiovascular Surgery
Volume51
Issue number11
DOIs
Publication statusPublished - Jan 1 2003
Externally publishedYes

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Hemostatics
Cardiopulmonary Bypass
Platelet Count
Blood Banks
Prothrombin Time
Thoracic Surgery
Blood Platelets
Hemorrhage
Postoperative Hemorrhage
Hemodilution
Perioperative Period
Partial Thromboplastin Time
Platelet Activating Factor
Body Weight
Pediatrics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Haemostatic Profile of Small Children during and following Cardiopulmonary Bypass. / Fukumura, Fumio; Sese, Akira; Ueno, Yasutaka; Imoto, Yutaka; Sakamoto, Masato; Tanoue, Yoshihisa; Sonoda, Hiromichi.

In: Japanese Journal of Thoracic and Cardiovascular Surgery, Vol. 51, No. 11, 01.01.2003, p. 577-581.

Research output: Contribution to journalArticle

Fukumura, Fumio ; Sese, Akira ; Ueno, Yasutaka ; Imoto, Yutaka ; Sakamoto, Masato ; Tanoue, Yoshihisa ; Sonoda, Hiromichi. / Haemostatic Profile of Small Children during and following Cardiopulmonary Bypass. In: Japanese Journal of Thoracic and Cardiovascular Surgery. 2003 ; Vol. 51, No. 11. pp. 577-581.
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abstract = "Objective: We evaluated changes of the haemostatic system during pediatric cardiac surgery during and after cardiopulmonary bypass (CPB). Method: Twenty-five children under 15 kg of body weight undergoing open-heart surgery were divided into three groups; 9 patients (Group A), no bank blood was used throughout the surgery; 8 patients (Group B), packed red cells were used in the priming of CPB circuit; 8 patients (Group C) in cyanotic condition, for whom surgery was performed without bank blood. CPB caused a significant decrease of platelet counts in all three groups, the levels of which remained similar next morning. Results: Platelet counts decreased more significantly in Group C (59±27 k/mm3) than in Group A (119±42 k/mm 3) and B (104±27 k/mm3). Platelet function-platelet activating factor test (HemoSTATUS™) did not significantly decrease throughout the perioperative period in Group A. HemoSTATUS™ value decreased during CPB and recovered after CPB in Group B and C. Prothrombin time international ratio (PT-INR) and activated partial thromboplastin time were significantly prolonged just after CPB and recovered until next morning in all three groups. PT-INR was more prolonged in Group C (2.92±0.62) than in Group A (2.08±0.27) and B (2.42±0.42). There was no significant difference in postoperative bleeding for the first 12 hours among the three groups. Conclusion: Although extreme hemodilution during CPB significantly impairs the coagulation and platelet system, these changes are usually transient and tolerable with minimal postoperative hemorrhage. However, a prolonged CPB and preoperative cyanotic condition may induce a critical decrease of platelet counts and increase postoperative bleeding.",
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AU - Sakamoto, Masato

AU - Tanoue, Yoshihisa

AU - Sonoda, Hiromichi

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N2 - Objective: We evaluated changes of the haemostatic system during pediatric cardiac surgery during and after cardiopulmonary bypass (CPB). Method: Twenty-five children under 15 kg of body weight undergoing open-heart surgery were divided into three groups; 9 patients (Group A), no bank blood was used throughout the surgery; 8 patients (Group B), packed red cells were used in the priming of CPB circuit; 8 patients (Group C) in cyanotic condition, for whom surgery was performed without bank blood. CPB caused a significant decrease of platelet counts in all three groups, the levels of which remained similar next morning. Results: Platelet counts decreased more significantly in Group C (59±27 k/mm3) than in Group A (119±42 k/mm 3) and B (104±27 k/mm3). Platelet function-platelet activating factor test (HemoSTATUS™) did not significantly decrease throughout the perioperative period in Group A. HemoSTATUS™ value decreased during CPB and recovered after CPB in Group B and C. Prothrombin time international ratio (PT-INR) and activated partial thromboplastin time were significantly prolonged just after CPB and recovered until next morning in all three groups. PT-INR was more prolonged in Group C (2.92±0.62) than in Group A (2.08±0.27) and B (2.42±0.42). There was no significant difference in postoperative bleeding for the first 12 hours among the three groups. Conclusion: Although extreme hemodilution during CPB significantly impairs the coagulation and platelet system, these changes are usually transient and tolerable with minimal postoperative hemorrhage. However, a prolonged CPB and preoperative cyanotic condition may induce a critical decrease of platelet counts and increase postoperative bleeding.

AB - Objective: We evaluated changes of the haemostatic system during pediatric cardiac surgery during and after cardiopulmonary bypass (CPB). Method: Twenty-five children under 15 kg of body weight undergoing open-heart surgery were divided into three groups; 9 patients (Group A), no bank blood was used throughout the surgery; 8 patients (Group B), packed red cells were used in the priming of CPB circuit; 8 patients (Group C) in cyanotic condition, for whom surgery was performed without bank blood. CPB caused a significant decrease of platelet counts in all three groups, the levels of which remained similar next morning. Results: Platelet counts decreased more significantly in Group C (59±27 k/mm3) than in Group A (119±42 k/mm 3) and B (104±27 k/mm3). Platelet function-platelet activating factor test (HemoSTATUS™) did not significantly decrease throughout the perioperative period in Group A. HemoSTATUS™ value decreased during CPB and recovered after CPB in Group B and C. Prothrombin time international ratio (PT-INR) and activated partial thromboplastin time were significantly prolonged just after CPB and recovered until next morning in all three groups. PT-INR was more prolonged in Group C (2.92±0.62) than in Group A (2.08±0.27) and B (2.42±0.42). There was no significant difference in postoperative bleeding for the first 12 hours among the three groups. Conclusion: Although extreme hemodilution during CPB significantly impairs the coagulation and platelet system, these changes are usually transient and tolerable with minimal postoperative hemorrhage. However, a prolonged CPB and preoperative cyanotic condition may induce a critical decrease of platelet counts and increase postoperative bleeding.

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