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[Hematologic changes induced by extracorporeal circulation].

A Watel, D Mathieu, A Pol

    Annales Francaises D'Anesthesie Et De Reanimation
    |January 1, 1985
    PubMed
    Summary
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    Extracorporeal circulatory circuits (ECC) activate plasma and cellular systems, causing moderate clotting factor changes and significant fibrinolysis. Heparin use helps manage these haemocompatibility challenges during procedures like cardiac surgery.

    Area of Science:

    • Biomedical Engineering
    • Haematology
    • Cardiovascular Surgery

    Context:

    • Extracorporeal circulatory circuits (ECC) are essential in various medical procedures, including cardiac surgery, plasma exchange, and haemoperfusion.
    • Assessing the haemocompatibility of these circuits is critical for patient safety and procedural success.
    • Heparin remains the primary anticoagulant to mitigate blood clotting activation during ECC use.

    Purpose:

    • To define the plasma and cellular changes associated with extracorporeal circulatory circuits.
    • To evaluate the haemocompatibility of these systems by analyzing blood alterations.
    • To understand the mechanisms behind early haemostatic and cellular responses to ECC.

    Summary:

    • ECC use leads to moderate decreases in clotting factors and inhibitors due to haemodilution, particularly in cardiac surgery and plasma exchange.

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  • Fibrinolysis is frequently activated during ECC, especially in cardiac surgery, and can manifest as an early burst in haemoperfusion.
  • Cellular changes include rapid onset of thrombocytopaenia (platelet reduction) and leukopaenia (white blood cell reduction), linked to platelet and complement activation, respectively.

    • Impact:

    • Understanding these haemocompatibility issues is crucial for optimizing ECC procedures and minimizing adverse events.
    • The rapid activation of plasma and platelet systems highlights the need for careful monitoring and management during ECC.
    • Findings contribute to improved strategies for anticoagulation and managing haemostatic balance in patients undergoing extracorporeal therapies.