Hematologic changes occurring with cardiac catheterization

Area of Science:

• Cardiovascular Medicine
• Hematology
• Medical Procedures

Background:

• Blood rheology is influenced by its composition.
• Cardiac catheterization involves blood sampling and administration of contrast media, fluids, and heparin.
• These interventions may alter blood cell counts and coagulation parameters.

Purpose of the Study:

• To investigate the effects of cardiac catheterization and associated interventions on blood cell counts and coagulation.
• To assess changes in white blood cells, red blood cells, and platelets.
• To evaluate alterations in partial thromboplastin time (PTT) following heparin and protamine administration.

Main Methods:

• Blood samples were collected from the femoral vein at three time points: before heparin, at the end of catheterization (before protamine), and after protamine administration.
• Measurements included white blood cell count, red blood cell count, platelet count, and partial thromboplastin time (PTT).
• Statistical analysis was performed to compare values at different time points and against control values.

Main Results:

• Cardiac catheterization led to significant reductions in white blood cells (8.1%), red blood cells (10%), and platelets (10.9%) compared to baseline.
• Protamine administration further decreased white blood cells (23%) and platelets (14%) but did not significantly alter red blood cell counts.
• Before protamine, PTT was elevated (1.5 times control), with 10 of 13 patients exceeding 100 seconds. Protamine partially reversed PTT, though incomplete reversal occurred in some patients without adverse events.

Conclusions:

• Cardiac catheterization and its interventions induce significant changes in blood cellular composition.
• These hematological alterations may influence hemodynamic measurements obtained during or after the procedure.
• While protamine can affect coagulation parameters, it appears to be safely managed in this patient cohort.