Platelet Functions in Cardiopulmonary Bypass Surgery

Area of Science:

• Cardiovascular Surgery
• Hematology
• Biomedical Engineering

Background:

• Post-cardiac surgery hemorrhage is a significant complication of cardiopulmonary bypass (CPB).
• Incidence ranges from 5-25%, associated with increased morbidity and mortality.
• Causative factors remain incompletely understood.

Purpose of the Study:

• To evaluate hemostatic defects, specifically platelet function abnormalities during CPB.
• To reduce morbidity and mortality associated with post-CPB hemorrhage.

Main Methods:

• Flow cytometric evaluation of platelet glycoproteins (GPIb/IX, GPIIb/IIIa, GMP-140).
• Assessment of platelet marker expression during and after CPB surgery.

Main Results:

• Platelet marker expression showed deregulation during surgery, returning to baseline post-bypass.
• Bleeding cases exhibited significant variations in marker expression.
• Decreased P-Selectin (GMP-140) expression correlated with severe bleeding, indicating impaired platelet activation.

Conclusions:

• Longer CPB duration may promote plasmin generation, affecting platelet function.
• A link exists between CPB duration, bleeding, platelet dysfunction, and fibrinolysis.
• Serial measurements of GMP-140 and tPA can predict severe post-CPB bleeding.