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Hypothermia and bleeding during abdominal aortic aneurysm repair
H A Kahn1, G R Faust, R Richard
1Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, N.Y. 11042.
Annals of Vascular Surgery
|January 1, 1994
Summary
Hypothermia significantly impairs platelet function during abdominal aortic aneurysm repair, leading to increased bleeding times. Maintaining normothermia may reduce surgical bleeding risks.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Anesthesiology
Background:
- Abdominal aortic aneurysm repair often involves hypothermia, which can affect coagulation.
- The impact of hypothermia versus heparin on platelet function during this procedure is not fully understood.
Purpose of the Study:
- To investigate the effects of hypothermia and heparin on platelet function in patients undergoing abdominal aortic aneurysm repair.
- To determine which factor, hypothermia or heparin, has a greater impact on bleeding times.
Main Methods:
- Prospective study of 10 patients undergoing abdominal aortic aneurysm repair.
- Hourly measurements of bleeding times and core body temperature.
- Intraoperative heparinization reversed with protamine sulfate.
Main Results:
- All patients developed hypothermia (mean lowest core temperature 34.8°C).
- A significant linear relationship was found between decreased core temperature and increased bleeding time.
- In most cases, prolonged bleeding correlated with the lowest core temperature, not heparinization.
Conclusions:
- Hypothermia significantly alters platelet function, contributing to prolonged bleeding during abdominal aortic aneurysm repair.
- Hypothermia appears to have a more pronounced effect on platelet function than heparin in this context.
- Preventing severe hypothermia (<35°C) could minimize surgical bleeding and reduce the need for blood transfusions.
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