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Prolonged extracorporeal circulation (ECC) for cardiac surgery results in coagulation abnormalities, most of which related to the direct, time dependent effect of the polymer tubing and the pump rollers on the thrombocytes. Significant evidence demonstrates the effect of the duration of cardiopulmonary bypass on thrombocytes number and function, as well as on postoperative coagulopathy
Quantification of the effect of ECC duration on blood coagulation and platelet number and function
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | patients scheduled for prolonged cardiac surgery (over 3 hours anticipated ECC time) with no known coagulation disorders |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in Platelet function apoptosis markers | Platelet apoptosis by annexin V (Flow cytometry) | 1st sample - less than 10 minutes after induction of anesthesia, 2nd sample - less than 3 minutes after termination of CPB, 3rd sample - 10 minutes after protamine administration for heparin reversal, after termination of CPB |
| Change in Platelet function activation markers | Platelet activation by P-selectin (Flow cytometry) | 1st sample - less than 10 minutes after induction of anesthesia, 2nd sample - less than 3 minutes after termination of CPB, 3rd sample - 10 minutes after protamine administration for heparin reversal, after termination of CPB |
| Measure | Description | Time Frame |
|---|---|---|
| Change in platelet count over time | Every 30 minutes - starting less than 10 minutes after induction of anesthesia, and for 7 hours or until termination of CPB and protamine administration - whichever comes first |
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Inclusion Criteria:
Exclusion Criteria:
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adults over 18 yo scheduled for prolonged cardiac surgery requiring ECC time over 3 hours,
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| ID | Term |
|---|---|
| D020141 | Hemostatic Disorders |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006474 | Hemorrhagic Disorders |
| D006402 | Hematologic Diseases |
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| D006425 |
| Hemic and Lymphatic Diseases |