The changes in coagulation and platelet function during cardiac surgery using SONOCLOT / 中华麻醉学杂志

ABSTRACT

Objective This study was designed to evaluate the change in coagulation and platelet function during cardiac surgery using SONOCLOT(SCT), a new coagulation and platelet function analyser which can analyse the whole process of coagulation including platelet function , fibrin formation and fibrinolysis with only 0 4ml of whole blood Methods Thirty ASA Ⅱ Ⅲpatients scheduled for cardiac surgery were studied 15 patients underwent valve replacement (group V) and another 15 patients coronary artery bypass graft (CABG, groupC) under combined intravenous and inhalation anesthesia Anesthesia was induced with midazolam 0 05mg?kg -1 ,fentanyl 5 10?g kg -1 or propofol 1 1 5mg?kg -1 and vecuronium 0 1 0 2mg?kg -1 and maintained with isoflurane(0 8 1 5MAC) supplemented with intermittent boluses of propofol and fentanyl ECG,SpO 2, P ET CO 2, BP, CVP, PAP, HCT and T were monitored during operation And dopamine, adrenaline, nitroglycerin, milrinone and other vasoactive drugs were used to maintain hemodynamic stability Blood samples were taken before anesthesia (T 1), after induction (T 2), after heparinization 3mg? kg -1 ( T 3) and 5min after protamine administration (T 4) for determination of ACT, clot rate and platelet function using SONOCLOT analysis Platelet counts were checked at T 1 and T 4 Results CPB time was less than 2h in all 30 patients Clot rate was significantly faster at T 2 than at T 1(P