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  • Meeting abstract
  • Open Access

Hemostatic and fibrinolysis markers in serum and shed mediastinal blood after elective coronary artery bypass grafting

  • 1,
  • 1,
  • 2,
  • 1 and
  • 1
Critical Care20026 (Suppl 1) :P149

https://doi.org/10.1186/cc1606

  • Published:

Keywords

  • Thrombin
  • Coronary Artery Bypass Grafting
  • International Normalize Ratio
  • Autologous Blood
  • Median Sternotomy

Objective

Reduction of homologous blood products in cardiac surgery is mainly achieved by autologous blood salvage. One of the most customary methods consists in autotransfusion of shed mediastinal blood within the first 6 hours after surgery. Aim of this prospective study was to compare serum and shed mediastinal blood qualities of hemostatic and fibrinolysis markers early after elective coronary artery bypass grafting (CABG).

Methods

Forty-seven patients (mean age 68.1 ± 6.9, 15 female/ 32 male) underwent first-time elective CABG with extracorporal circulation via median sternotomy. Activated partial thromboplastin time (aPTT), prothrombin time (Quick's value), international normalized ratio (INR), thrombin time, and fibrinogen (factor I) in arterial blood and shed mediastinal blood were measured after admission to the ICU and 6 hours after unclamping the aorta.

Results

Mean loss of mediastinal shed blood was 207 ± 127 ml within the first 6 hours after unclamping the aorta. All tests showed that the shed mediastinal blood contained significantly elevated concentrations or activities of all biochemical parameters indicating blood activation or clotting (Table 1).

Table 1

 

After admission to the ICU

6 hours after unclamping the aorta

 

Shed blood

Serum

P

Shed blood

Serum

P

Quick's value (%)

34

83

< 0.001

22

92

< 0.001

INR

2

1.18

< 0.001

2.12

1.1

< 0.001

APTT (s)

> 120

52

< 0.001

> 120

46

< 0.001

Thrombin time (s)

> 120

18.6

< 0.001

> 120

14.9

< 0.001

Fibrinogen (mg/dl)

121

70.5

< 0.001

40

281

< 0.001

Conclusions

Mediastinal shed blood is excessively activated regarding coagulation and fibrinolysis. In patients undergoing transfusion of higher quantities of shed blood might cause postoperative excessive bleeding.

Authors’ Affiliations

(1)
Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, D-55131, Germany
(2)
Institute of Clinical Chemistry, University Hospital Mainz, Mainz, D-55131, Germany

Copyright

© Biomed central limited 2001

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