Abstract
Cardiopulmonary bypass (CPB) best of all defines the state of blood coagulation system and accordingly the quantity
of postoperative blood loss and need of hemotransfusions. The aim of the present investigation is to study prognostic
value of some or other conditions of perfusion procedure with the assessment of perioperative hemorrhagic
complications risk and ways of their prevention in children with congenital heart defects.
Retrospective nonrandomized cohort study included 1261 patients aged 0 - 14 years old. 1285 consecutive procedures
of congenital heart defects correction under cardiopulmonary bypass were performed during one calendar
year. The terms of the study were perioperative hemorrhages and blood loss, postoperative hemorrhages and blood
loss, need of blood preparations transfusions.
CPB time (p = 0.006) and hypothermia rate (p = 0.021) had the prognostic properties within the context of multifactor
logistic model in which as independent variables were incorporated all perioperative factors correlating with
postoperative hemorrhage. Perioperative hemorrhages determine CPB duration increase and hypothermia exacerbation
which as a whole form a background for the development of hemostasis system disorders in any case of this
complication regardless of the blood loss intensity.
Since CPB time integrates practically all the rest parameters of perfusion, somehow influences the rate of intra- and
postoperative blood loss, volume of hemotransfusions this value can be considered as an independent predictor of
hemorrhagic complications. CPB estimated or real duration over 150 minutes requires hemostatic procedures optimization.
Cardiopulmonary bypass influence on blood coagulation system is multidimentional but not stereotyped. Its various
constituents are under the influence of various CPB-associated disorders which makes it possible to predict
potential hemostatic changes due to estimated or real conditions of perfusion procedure.
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