| Cardiopulmonary bypass parameters and hemostatic response to cardiopulmonary bypass in infants versus children. | |
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MedLine Citation:
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PMID: 18249331 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Because infants have relatively more blood loss (mL/kg) than older children during cardiac surgery involving cardiopulmonary bypass (CPB), the authors compared hemostatic activation between infants and older children undergoing cardiac surgery. DESIGN: Observational study. SETTING: University-affiliated children's hospital. PARTICIPANTS: Twenty-eight children (18 infants <1 year and 10 children >1 year) undergoing cardiac surgery with CPB. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Markers of coagulation and fibrinolysis were evaluated at 9 sample points before, during, and after CPB in the 28 children. Infants had greater chest tube output, longer CPB times, and a larger drop in platelet counts during CPB than children. Active tissue plasminogen activator (tPA) increased during CPB in both groups, with infants showing lower levels than children (p < 0.001). In both groups, active plasminogen activator inhibitor type 1 (PAI-1) first decreased during CPB and then increased above baseline postoperatively. Infants had higher PAI-1 than children near the end of CPB (p = 0.01). Thrombin-antithrombin complex levels increased during and after CPB, with infants showing lower levels only during CPB (p = 0.01). D-dimer and prothrombin activation peptide (F1.2) levels increased in a similar pattern for both groups during and after CPB. The length of aortic cross-clamp time and the level of F1.2 after protamine administration correlated significantly and independently with 12-hour chest tube output. CONCLUSIONS: Compared with children, infants had greater blood loss (mL/kg), greater drop in platelets during CPB, lower active tPA, and higher active PAI-1. Cumulative thrombin generation after CPB, indicated by F1.2 levels, correlated with early blood loss. |
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Authors:
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Michael J Eisses; Wayne L Chandler |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2007-08-22 |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 22 ISSN: 1532-8422 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-02-05 Completed Date: 2008-05-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 53-9 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA. michael.eisses@seattlechildrens.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Age Factors Blood Coagulation* Blood Loss, Surgical* Cardiopulmonary Bypass* Child Child, Preschool Female Fibrin Fibrinogen Degradation Products / analysis Fibrinopeptide A / analysis Humans Infant Male Monitoring, Intraoperative Plasminogen Activator Inhibitor 1 / analysis Platelet Count Thrombin / metabolism Time Factors Tissue Plasminogen Activator / blood |
| Grant Support | |
ID/Acronym/Agency:
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M01-RR-00037/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrin Fibrinogen Degradation Products; 0/Plasminogen Activator Inhibitor 1; 0/fibrin fragment D; 25422-31-5/Fibrinopeptide A; EC 3.4.21.5/Thrombin; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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