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Changes in hemostas...
Changes in hemostasis during pediatric heart surgery: impact of a biocompatible heparin-coated perfusion system.
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- Jensen, Eva (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Andréasson, Svenerik (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Bengtsson, Anders, 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Berggren, Håkan, 1951 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Ekroth, Rolf, 1944 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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- Larsson, Lars E (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
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- Ouchterlony, John (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna,Institute of Surgical Sciences
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(creator_code:org_t)
- Elsevier BV, 2004
- 2004
- English.
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In: The Annals of thoracic surgery. - : Elsevier BV. - 0003-4975. ; 77:3, s. 962-7
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Abstract
Subject headings
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- BACKGROUND: This study describes the response in hemostasis during open-heart surgery with cardiopulmonary bypass (CPB) in children (<== 10 kg) and tests the hypothesis that the use of a biocompatible perfusion system, in comparison with a conventional system, causes less hemostatic activation. METHODS: Prospective, randomized, controlled clinical study. Forty consecutive children <== 10 kg were included and divided into two groups: group bioc. (n = 19) treated with a fully heparin-coated system, centrifugal pump, and a closed circuit, and group conv. (n = 21) treated with an uncoated system, roller pump, and a hard shell venous reservoir. Concentrations of plasma thrombin-antithrombin (TAT), D-dimer, tissue plasminogen activator antigen (t-PA ag), and the complex consisting of tissue plasminogen activator and its inhibitor plasminogen activator inhibitor-1 (t-PA-PAI-1) were measured. RESULTS: The biochemical variables measured increased significantly in both groups during the study period. There was less activation of fibrinolysis during cardiopulmonary bypass (t-PA ag: p = 0.009) in patients treated with the biocompatible perfusion system than in patients treated with the conventional system. A trend in favor of the biocompatible system based on the D-dimer and TAT data (p = 0.07 for both measurements) was observed but no significant intergroup differences regarding these variables or t-PA-PAI-1 were found. CONCLUSIONS: Open-heart surgery with cardiopulmonary bypass in children (<== 10 kg) causes transient activation of the coagulation and fibrinolytic systems. This study demonstrates that the use of a biocompatible perfusion system results in a lower extent of activation of fibrinolysis during CPB than the use of a conventional system.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Anticoagulants
- Antithrombin III
- Cardiac Surgical Procedures
- Cardiopulmonary Bypass
- instrumentation
- Coated Materials
- Biocompatible
- Female
- Fibrin Fibrinogen Degradation Products
- analysis
- Hemostasis
- physiology
- Heparin
- Humans
- Infant
- Male
- Peptide Hydrolases
- blood
- Perfusion
- instrumentation
- Plasminogen Activator Inhibitor 1
- blood
- Prospective Studies
- Tissue Plasminogen Activator
- blood
Publication and Content Type
- ref (subject category)
- art (subject category)
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