کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2827939 | 1162472 | 2009 | 4 صفحه PDF | دانلود رایگان |
A number of associations with post-bypass bleeding have been described in the accompanying paper. Herein we hypothesize that dilution is an underlying cause through a malign series of bypass-associated events.Heparinized blood behaves anomalously when diluted. Clotting times first shorten somewhat, then – as the dilution of whole blood approaches 50% – rapidly lengthen to unclottability. During cardiopulmonary bypass, low blood volume patients are at a significant risk of clotting factor dilution which will always be more severe than the level of whole blood dilution. If severe enough, this dilution may lower plasma clotting factors to a critical level and may result in excess protamine administration, secondary to overestimation of heparin. The presence of un-neutralized protamine combined with critically lowered clotting factors leads to marked coagulopathy.
Journal: Blood Cells, Molecules, and Diseases - Volume 43, Issue 3, November–December 2009, Pages 256–259