| Comparison of blood activation in the wound, active vent, and cardiopulmonary bypass circuit. | |
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MedLine Citation:
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PMID: 18640330 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: During cardiopulmonary bypass, aspirated blood exhibits strong activation features, but the triggering event remains unclear. Contact of blood with the pericardial cavity and surgical wound has been advocated as the main trigger, but suction forces are also considered as a possible contributor. We thus designed a study to identify the possible causes involved in this activation. METHODS: In 10 patients, we analyzed hemostasis activation markers and inflammatory mediators in blood collected in the pericardial cavity and in blood actively aspirated from the left ventricle without any contact with the pericardial cavity. In addition, the same variables were determined in blood sampled in the cardiopulmonary bypass circuit. RESULTS: Markers of tissue factor pathway activation and of thrombin generation, microparticles, free hemoglobin, interleukin 6, and tumor necrosis factor-alpha were significantly increased in pericardial samples as compared with the left ventricle and cardiopulmonary bypass circuit samples. All measured variables were similar between left ventricle and cardiopulmonary bypass samples, except free hemoglobin, interleukin 6, and microparticle levels, which were significantly higher in the left ventricle. CONCLUSIONS: Blood contact with the pericardial cavity induces strong hemolysis, inflammatory mediator release, and coagulation activation, driven by tissue factor pathway activation. By contrast, suction forces applied to left ventricular blood poorly contribute to blood trauma and activation. Comparison of pericardial and left ventricular blood shows that contact with the pericardial cavity, and not suction forces, is the leading cause of blood activation. The specific trigger for blood trauma and activation present in the pericardial cavity remains to be identified. |
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Authors:
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Olivier Fabre; André Vincentelli; Delphine Corseaux; Francis Juthier; Sophie Susen; Anne Bauters; Eric Van Belle; Frédéric Mouquet; Thierry Le Tourneau; Christophe Decoene; Francis Crépin; Alain Prat; Brigitte Jude |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 86 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-21 Completed Date: 2008-09-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 537-41 Citation Subset: AIM; IM |
Affiliation:
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Centre Hospitalier Régional Universitaire de Lille, Clinique de Chirurgie Cardiovasculaire, Lille, France. o-fabre@chru-lille.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / surgery Blood Coagulation / physiology* Cardiopulmonary Bypass* / methods Coronary Artery Bypass* Female Flow Cytometry Heart Arrest, Induced Humans Inflammation Mediators Male Middle Aged Pericardium / physiology* Platelet Activation / physiology Thromboplastin / analysis, physiology* |
| Chemical | |
Reg. No./Substance:
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0/Inflammation Mediators; 9035-58-9/Thromboplastin |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2008 Aug;86(2):541-2
[PMID:
18640331
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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