Cardiopulmonary bypass and the coagulation system
نویسندگان
چکیده
Cardiopulmonary bypass exerts intended and unintended effects on the enzymatic and formed elements of the coagulation and inflammatory systems. Compared with adults, children are at special risk for known, and unknown, differences in their hemostatic systems. Management of these risks will be presented from a surgical perspective, supporting those strategies with a combination of peer-reviewed data and empiric experience. Preoperatively, strategies discussed are management of preoperative anticoagulants, autologous and directed donation, erythropoietin, and special considerations in the care of pediatric Jehovah’s Witnesses. Intraoperatively, strategies discussed include basic management of cardiopulmonary bypass, heparin and heparin monitoring, protamine, alternative anticoagulant strategies for heparin sensitivity, and intraoperative pharmacologic adjuncts promoting postoperative hemostasis. Postoperative strategies discussed include blood product utilization, recombinant factor VII, the use of thromboelastography to guide therapy, topical strategies, cell saver therapy, and surgical reexploration. D 2005 Published by Elsevier Ireland Ltd.
منابع مشابه
Cardiopulmonary Bypass, Inflammation and How to Defy it: Focus on Pharmacological Interventions
One of the most common health problems are diseases of the cardiovascular system with a great bulk of disease burden; while a considerable number of cardiac patients undergo cardiac surgery; cardiac surgical procedures with cardiopulmonary bypass (CPB) are nowadays among the top list of surgical procedures. More than half of a century has passed since the introduction of total cardiopulmonary b...
متن کاملCardiopulmonary Bypass, Inflammation and How to Defy it: Focus on Pharmacological Interventions
One of the most common health problems are diseases of the cardiovascular system with a great bulk of disease burden; while a considerable number of cardiac patients undergo cardiac surgery; cardiac surgical procedures with cardiopulmonary bypass (CPB) are nowadays among the top list of surgical procedures. More than half of a century has passed since the introduction of total cardiopulmonary b...
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