Introduction. Advancements in extracorporeal circuits for artificial blood circulation promote the search for new lab assays to manage hemostasis in cardiopulmonary bypass surgery.
Aim: is to monitor measurements of thrombodynamics and thromboelastometry tests in cardiac surgery patients who underwent surgery with minimally invasive extracorporeal circulation (MiECC) in blood flow assisted setting.
Material and methods. The trial included 50 patients with ischemic heart disease who were referred for blood flow assisted cardiopulmonary bypass surgery: group 1 – 15 patients who underwent cardiopulmonary bypass surgery with the use of MiECC vs. group 2 – 35 patients who underwent cardiopulmonary bypass surgery with conventional extracorporeal circuits. Dynamic lab testing was performed preoperatively, after protamine sulfate injection, 12 hours after surgery, 7 days after surgery, at discharge, and 1 month after surgery. In all patients, venous blood was derived for global assays to evaluate hemostasis – thromboelastometry and thrombodynamics tests.
Results.Postoperatively (12 hours and 1 month after surgery) both groups showed shorter clot formation time (CFT, sec) and faster clot growth (V, m/min) which suggests intensive procoagulant activity of hemostasis. After protamine sulfate administration the value of V (m/min) in group 1 and 2 demonstrated statistically significant decrease versus initial values (p=0.009 and p=0.000). Value of V (m/min) and Vst. (m/min) this could be used as an important measurement to evaluate efficiency of heparin neutralization. Spontaneous clotting Tsp (min) was observed in both groups during the entire trial period, except the time interval of sodium heparin neutralization and on day 7 postoperatively.
Conclusion. Thrombodynamics test basic (V, Tlag, Tsp) and additional (Vi, CS, D) parameters, as well as thromboelastometry parameters demonstrate a hypercoagulation shift in plasma hemostasis which was more evident in patients who underwent cardiopulmonary bypass surgery with conventional extracorporeal circuits.
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About the authors
- Vyacheslav I. Кornev, Head of Department, orcid.org/0000-0002-5352-6466
- Nataliya M. Кalinina, Dr. Med. Sc., Chief Researcher, orcid.org/0000-0003-1752-6888
- Ol’ga N. Startseva, Cand. Biol. Sc., Biologist, orcid.org/0000-0003-3524-3603