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Platelet function during cardiac operation: comparison of membrane and bubble oxygenators
The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1982
Summary
Cardiopulmonary bypass affects platelet function, causing similar decreases in aggregation sensitivity and increased bleeding times regardless of oxygenator type. Platelet counts and granule contents remain largely unchanged with membrane oxygenators.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Biomedical Engineering
Background:
- Cardiopulmonary bypass (CPB) is essential for cardiac surgery but can affect hemostasis.
- Different oxygenator systems, bubble and membrane, are used during CPB.
- Understanding their impact on platelet function is crucial for patient outcomes.
Purpose of the Study:
- To compare the effects of bubble and membrane oxygenator systems on platelet function during CPB.
- To investigate changes in platelet count, aggregation, and release markers.
Main Methods:
- Studied 26 patients undergoing coronary artery bypass grafts.
- Compared 14 patients on membrane oxygenators vs. 12 on bubble oxygenators.
- Assessed platelet counts, adenosine diphosphate (ADP)-induced aggregation, plasma low affinity platelet factor 4 (LA-PF4), and bleeding times.
Main Results:
- Platelet counts decreased post-CPB but normalized with membrane oxygenators; increased with bubble oxygenators.
- Both systems reduced platelet sensitivity to ADP and increased bleeding times.
- Plasma LA-PF4 increased in both groups; platelet LA-PF4 and adenine nucleotides were stable with membrane oxygenators.
Conclusions:
- CPB with both bubble and membrane oxygenators causes similar qualitative platelet dysfunction.
- Mechanisms of CPB-induced platelet alteration are not fully elucidated but may not involve granule content depletion with membrane systems.