Problems in Hemostasis During Open-Heart Surgery* IV

Abstract

VARIOUS changes in the coagulation mechanism develop during extracorporeal circulation. These changes involve the cellular as well as the plasmatic constituents of blood Thrombocytopenia and red cell destruction have been noted during extracorporeal circulation (Brown et al.,1 DeWall et al.,6, 7 Milnes et al.,19 Nilsson et al.,21 Osborn et al.,22, 23 Wright et al.26) Decline of the fibrinogen concentration during cardio-pulmonary bypass procedures in dogs has been described by Osborn et al.22 and Wright et al.26 This observation has been confirmed in humans by Nilsson et al.21 Similarly, a decline in the prothrombin concentration too was noted by the latter investigators Previous studies from this laboratory have indicated that during extracorporeal circulation there is an increased plasminogen activator activity.11 Therapeutic trial with Epsilon Amino Caproic Acid diminished this fibrinolytic activity.13 The present study is a summary of changes of coagulation parameters in patients during cardiopulmonary bypass procedures