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Platelet dysfunction associated with cardiopulmonary bypass.

W R Friedenberg, W O Myers, E D Plotka

    The Annals of Thoracic Surgery
    |April 1, 1978
    PubMed
    Summary
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    Cardiopulmonary bypass impairs platelet function, causing storage pool deficiency and abnormal membranes. This platelet dysfunction occurs similarly with both membrane and bubble oxygenators, impacting clinical outcomes.

    Area of Science:

    • Hematology
    • Cardiovascular Surgery

    Background:

    • Platelet dysfunction is a known complication following cardiopulmonary bypass (CPB).
    • The impact of different oxygenator types (membrane vs. bubble) on CPB-induced platelet dysfunction requires further elucidation.

    Purpose of the Study:

    • To investigate the clinical significance and pathogenesis of platelet dysfunction after CPB.
    • To compare functional impairment associated with membrane and bubble oxygenators.

    Main Methods:

    • Prospective study of 40 patients undergoing CPB.
    • Preoperative and postoperative laboratory tests including CBC, platelet count, coagulation profiles, and platelet aggregation.
    • Specialized tests: 14C-serotonin uptake, electron microscopy, in vitro aggregation studies with protamine sulfate and hemoglobin.

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    Main Results:

    • Abnormal platelet aggregation was observed post-CPB, with no significant difference between membrane and bubble oxygenator groups.
    • In vitro studies and electron microscopy suggested acquired storage pool deficiency and altered platelet membrane characteristics.

    Conclusions:

    • CPB induces platelet dysfunction characterized by storage pool deficiency and abnormal membrane properties.
    • Both membrane and bubble oxygenators appear to contribute similarly to CPB-associated platelet impairment.