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Plasma activity of individual coagulation factors, hemodilution and blood loss after cardiac surgery: a prospective

Lisa Ternström1, Vladimir Radulovic, Martin Karlsson

  • 1Department of Cardiovascular Surgery and Anesthesia, Sahlgrenska University Hospital, Gothenburg, Sweden.

Thrombosis Research
|June 29, 2010
PubMed

Insights

Coagulation factor levels change significantly after coronary artery bypass grafting (CABG). Lower fibrinogen and Factor XIII activity correlate with increased postoperative bleeding in CABG patients.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Coagulation Science

Background:

  • Cardiopulmonary bypass during CABG can lead to hemodilution and consumption of coagulation factors.
  • This may contribute to bleeding complications observed post-cardiac surgery.

Purpose of the Study:

  • To investigate the activity of individual coagulation factors following CABG.
  • To assess the relationship between coagulation factor activity, hemodilution, and postoperative bleeding.

Main Methods:

  • Analyzed plasma concentrations of fibrinogen and activity of factors II, V, VII, VIII, IX, X, XI, and XIII in 57 CABG patients.
  • Measurements were taken before, 2 hours, and 24 hours after surgery, adjusted for hemodilution.
  • Correlated coagulation factor activity with registered postoperative bleeding volumes.

Main Results:

  • Significant reductions in fibrinogen, Factors II, V, X, and XIII were observed 2 hours post-surgery.
  • Factors VIII and IX showed increased activity post-surgery, while FVII and FXI remained unchanged.
  • Twenty-four hours post-surgery, fibrinogen, Factor VIII, and Factor IX levels increased, while FVII, FXI, and FXIII decreased.
  • Postoperative blood loss correlated inversely with fibrinogen levels at 2 hours and Factor XIII activity (pre- and post-surgery).

Conclusions:

  • Coagulation factor activity exhibits significant dissociation after CABG.
  • Fibrinogen concentration and Factor XIII activity are key predictors of reduced postoperative bleeding after CABG.
Abstract

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