Control of Blood Coagulation During Cardiopulmonary By pass.

Abstract

INTRODUCTION:

Despite many technological modifications to the cardio-pulmonarv bypass (CPB) equipment, pathological conditions arising as ‘a consequence of changes to blood constituents remains a sign ificant cause of morbidity and mortality. Clinic ally, coagulation problems associated with CPB fall into three general categories. 1) Activation• of coagulation mechanisms by the non-biological surface the CPB equipment, expressed as embolic phenomena and obstruction of the CPB equipment. The ideal control of platelet numbers and function during CPB suggests the total inhibition of platelet activation immediately prior to, and during CPB, with rapid normalisation of platelet function at decannulation. Paradoxically, platelet function may need re-suppression during the period of post-operative hypercoagulab ility, when 10% of graft rethromboses are reported to occur.

CONCLUSION:

In which areas may the haematology 1aboratory be of assistance to the cardiothoracic surgeon. The reported incidence of graft re-thrombosis in the first post-operative week is approximately 10%, and occurs during a phase of definite hypercoagulability. It is clear that a disturbed coagulation system may givç rise to serious pathology during the post-operative phase, and that better understanding of these changes may reduce the morbidity and mortal ity of this procedure.