Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Chapter 16 - Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
Published online by Cambridge University Press: 24 October 2022
Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Summary
CPB as well as surgical trauma have a significant impact on the usually well-balanced coagulation system. This often leads to bleeding complications, and interventions to restore this balance are frequently attempted perioperatively. The coagulation and inflammatory systems are so complex that restoration of homeostatic balance cannot be achieved by giving blood products alone. Major known causes of CPB associated coagulopathy are dilution, complex and variable platelet dysfunction, fibrinolysis, the effects of heparin and protamine, hypocalcemia, hypothermia, as well as activation of the coagulation system after contact with artificial surfaces and from tissue factor release from the endothelium in response to ischemia and reperfusion.
Keywords
- Type
- Chapter
- Information
- Cardiopulmonary Bypass , pp. 156 - 165Publisher: Cambridge University PressPrint publication year: 2022
References
Suggested Further Reading
Besser, MW, Klein, AA. The coagulopathy of cardiopulmonary bypass. Crit Rev Clin Lab Sci. 2010; 47: 197–212.CrossRefGoogle ScholarPubMed
Hofer, J, Fries, D, Solomon, C et al. A snapshot of coagulopathy after cardiopulmonary bypass. Clin Appl Thromb Hemost. 2016; 22: 505–511.CrossRefGoogle ScholarPubMed
Task Force on Patient Blood Management for Adult Cardiac Surgery of the European Association for Cardio-Thoracic S, the European Association of Cardiothoracic A, Boer C et al. 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth. 2018; 32: 88–120.Google Scholar
Ortmann, E, Besser, MW, Klein, AA. Antifibrinolytic agents in current anaesthetic practice. Br J Anaesth. 2013; 111: 549–563.Google Scholar
Jassar, AS, Ford, PA, Haber, HL et al. Cardiac surgery in Jehovah’s Witness patients: ten-year experience. Ann Thorac Surg. 2012; 93: 19–25.CrossRefGoogle ScholarPubMed
Tanaka, A, Ota, T, Uriel, N et al. Cardiovascular surgery in Jehovah’s Witness patients: The role of preoperative optimization. J Thorac Cardiovasc Surg. 2015; 150: 976-83.e1–3.Google Scholar
Vaislic, CD, Dalibon, N, Ponzio, O et al. Outcomes in cardiac surgery in 500 consecutive Jehovah’s Witness patients: 21 year experience. J Cardiothorac Surg. 2012; 7: 95.CrossRefGoogle ScholarPubMed
Patel, PA, Ghadimi, K, Coetzee, E et al. Incidental cold agglutinins in cardiac surgery: Intraoperative surprises and team-based problem-solving strategies during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2017; 31: 1109–1118.Google Scholar
Jain, MD, Cabrerizo-Sanchez, R, Karkouti, K et al. Seek and you shall find – but then what do you do? Cold agglutinins in cardiopulmonary bypass and a single-center experience with cold agglutinin screening before cardiac surgery. Transfus Med Rev. 2013; 27: 65–73.Google Scholar