Study on relation between phases of open heart surgery with cardiopulmonary bypass and coagulation parameters / Монголын Анагаах Ухаан

ABSTRACT

Background: Cardiac surgery with cardiopulmonary bypass is grown rapidly in last years. Theapplication of cardiopulmonary bypass using a heart-lung machine to perform open heart surgeryis known to be associated with numerous pathophysiologic changes including injury of cellularcomponents as erythrocyte, platelets, coagulopathy, and fibrinolysis.Objectives: Our study objective is to study on relation of open heart surgery phases and bloodcoagulation parameters.Materials and Methods: Blood samples from 49 patients (28 females and 21 males, aged 18-63 years) who underwent open heart surgery with cardiopulnonary bypass (CPB) were collectedbefore and at several time points during, after surgery and analyzed for coagulation parametersat Shastin Third Central Hospital.Results: To compare long continued cardiopulmonary bypass (over 1 h) surgery with less 1h groups there prothrombin time was found 18.8±5.9 sec, international normalized ratio (INR)2.09±0.9 sec prolonged (p<0.001) in 7 days after surgery. All coagulation parameters weredecreased significantly (p<0.001) in during extracorporeal circulation and after 1 h declampingthan preoperative level and reached near normal value in 48 h after surgery. Our results havereferred to platelet counts reduction to about 53% in during surgery, 46.8% in 48 h after surgeryof the preoperative level 237.4±57.1 with final return to normal levels 228.9±78.6 within 7 days.Conclusions:1. The cardiopulmonary bypass time and patient age in relation to open heart surgery type therewere significant difference (p <0.01).2. The coagulation parameters have revealed significant changes (p <0.01) in relationcardiopulmonary bypass time.3. All coagulation parameters were decreased significantly (p<0.001) in during extracorporealcirculation and after 1 h decamping than preoperative level and reached near normal value in48 h after surgery.4. There was direct and less correlation between platelet level and CPB time (r=0.37, p<0.001).