Coagulopathy and Platelet Dysfunction associated with Cardiopulmonary Bypass
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Accession number;05A0625472
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| Title;Coagulopathy and Platelet Dysfunction associated with Cardiopulmonary Bypass |
| Author;
KATORI NOBUYUKI
(Sch. of Med., Keio Univ.)
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Journal Title;Japanese Journal of Intensive Care Medicine
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Journal Code:Z0581B
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ISSN:0389-1194
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VOL.29;NO.5;PAGE.371-379(2005)
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| Figure&Table&Reference;FIG.5, REF.33 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Bleeding associated with cardiopulmonary bypass (CPB) is one of the most common complications in cardiac surgery and is also difficult to treat. The complexity of this problem is related to the hemostatic process and many uncontrolled factors associated with CPB, including the effects of heparin, protamine, hemodilution, hypothermia, and the use of oxygenator. Although there are multiple and complicated changes in hemostatic process during CPB, the loss of platelet function is the most common and clinically relevant. This platelet dysfunction occurs in all patients undergoing CPB. In combination with the loss of coagulation factors, this platelet dysfunction promotes bleeding complications. Pharmacological agents such as aprotinin, tranexamic acid and aminocaproic acid have been introduced to improve hemostasis after CPB. The prophylactic administration of protease inhibitor aprotinin promises the reduction of bleeding associated with CPB. Aprotinin also provides new insights into the mechanism of CPB induced platelet dysfunction. Platelet anesthesia using glycoprotein IIb/IIIa inhibitor and/or nitric oxide may also provide novel concepts of platelet preservation during CPB. The management of bleeding associated with CPB will continue to improve. (author abst.) |
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