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Relationship between perioperative cardiopulmonary bypass time, platelet count, fibrinogen level, rotational thromboelastometry data, antithrombin level, and blood loss volume and the effects of deep hypothermic circulatory arrest: An observational study.
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- Additional Information
- Source:
Publisher: SAGE Publications Country of Publication: England NLM ID: 8700166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-111X (Electronic) Linking ISSN: 02676591 NLM ISO Abbreviation: Perfusion Subsets: MEDLINE
- Publication Information:
Publication: London : SAGE Publications
Original Publication: [London] : Edward Arnold, [c1986-
- Subject Terms:
- Abstract:
Introduction: We hypothesized that perioperative fibrinogen level, platelet count, and rotational thromboelastometry (ROTEM) data values decrease in proportion to cardiopulmonary bypass (CPB) time, particularly in patients who underwent deep hypothermic circulatory arrest (DHCA).
Methods: A total of 160 patients were enrolled and divided into the following three groups depending on CPB time: <2-h, 2- 3-h, and >3-h groups. Blood samples were obtained during CPB weaning. Platelet count, ROTEM data, fibrinogen level, and antithrombin level were determined. For propensity matching, we selected 15 patients who underwent DHCA and 15 patients who did not undergo DHCA and used propensity scores to match CPB time and other characteristics.
Results: The <2-h, 2-3-h, and >3-h groups included 74, 63, and 23 patients, respectively. No significant differences in platelet count and fibrinogen level were observed between the groups. Antithrombin level and amplitude of clot firmness at 10 min in the EXTEM and FIBTEM tests were lowest in the >3-h group. Similarly, blood loss volume and transfusion volume were highest in the >3-h group. Significant differences in platelet count, ROTEM data, lowest esophageal and bladder temperatures, and transfusion volume were observed between patients who underwent DHCA and patients who did not undergo DHCA.
Conclusions: The longer the CPB time, the greater the perioperative blood loss volume and transfusion volume, particularly if CPB time is greater than 3 hours. Sub-group analysis revealed that DHCA affects perioperative platelet count and function as well as blood loss volume.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Contributed Indexing:
Keywords: Thromboelastometry; blood loss; cardiopulmonary bypass; cardiovascular surgery; deep hypothermic circulatory arrest
- Molecular Sequence:
UMIN-CTR 000017412
- Accession Number:
9001-32-5 (Fibrinogen)
0 (Antithrombins)
- Publication Date:
Date Created: 20230306 Date Completed: 20240510 Latest Revision: 20241121
- Publication Date:
20241122
- Accession Number:
10.1177/02676591231161762
- Accession Number:
36877936
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