Title

The hemostatic defect of cardiopulmonary bypass

UMMS Affiliation

Department of Pediatrics

Date

12-2003

Document Type

Article

Medical Subject Headings

Blood Platelet Disorders; Cardiopulmonary Bypass; Fibrinolysis; Hemodilution; Hemorrhage; *Hemostasis; Heparin; Humans

Disciplines

Hematology | Oncology | Pediatrics

Abstract

Cardiac surgery involving cardiopulmonary bypass is a common yet complex procedure that results in considerable disruption of hemostasis during and following surgery. Despite the relatively common and widespread use of this procedure, there remains a significant peri-operative risk of both thrombosis and hemorrhage in some patients. This is known as the hemostatic defect of cardiopulmonary bypass. Strategies including the use of pharmacological agents, hemodilution, autologous blood transfusion, rapid in-theatre monitoring of hemostatic potential with fine-tuning of the degree of heparinization, minimally invasive surgery and the use of biologically coated cardiopulmonary bypass equipment have been employed to ameliorate the effects of cardiopulmonary bypass on hemostasis. However there exists a fine line between preventing hemorrhage and promoting thrombosis. Likewise attempts to prevent thrombosis may result in increased hemorrhage. Research into many strategies for minimizing the hemostatic defect of cardiopulmonary bypass is incomplete, with safety and efficacy the subjects of intensive investigation.

Rights and Permissions

Citation: J Thromb Thrombolysis. 2003 Dec;16(3):129-47. doi 10.1023/B:THRO.0000024051.12177.e9

Keywords

Link to article in PubMed