Predictive value of coagulation testing in cardiopulmonary bypass surgery

Severe postoperative bleeding in cardiopulmonary bypass surgery is still a major problem. One hundred and seven patients undergoing uncomplicated coronary artery bypass grafting (CABG) were studied. Two groups were formed according to the patients' 24 hours postoperative mediastinal blood loss. Patients in group I (n = 70) had blood loss less than 1000 ml and patients in group II (n = 33) had blood loss over 1000 ml. Between the two groups, there were no differences in age, male-female ratio, number of grafts, by pass-time or heparin-protamine dose. Coagulation testing: APTT (Activated Partial Thromboplastin Time), PT (Prothrombin Time), fibrinogen, D-dim. (D-dimers), bleeding time, MPV (mean platelet volume) and platelet count, was done preoperatively (T0), immediately postoperatively (T1), 6 hours postoperatively (T2). We were especially interested in the predictive value of hemostatic parameters at T0 and T1. We found a slight but statistically negative correlation between the platelet count (T0 and T1) and the postoperative blood loss.