Thorac cardiovasc Surg
DOI: 10.1055/s-0039-1677836
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Pericardial fluids or Cardiopulmonary Bypass—Is There a Major Culprit for Changes in Coagulation and Inflammation?

Hagen Gorki
1  Herz-, Thorax- und Gefäßchirurgie, Universitätsklinik Ulm, Ulm, Germany
,
Julia Nakamura
1  Herz-, Thorax- und Gefäßchirurgie, Universitätsklinik Ulm, Ulm, Germany
,
Andreas Kunert
1  Herz-, Thorax- und Gefäßchirurgie, Universitätsklinik Ulm, Ulm, Germany
,
Markus Hoenicka
1  Herz-, Thorax- und Gefäßchirurgie, Universitätsklinik Ulm, Ulm, Germany
,
Andreas Liebold
1  Herz-, Thorax- und Gefäßchirurgie, Universitätsklinik Ulm, Ulm, Germany
› Author Affiliations
Further Information

Publication History

31 July 2018

21 December 2018

Publication Date:
06 February 2019 (online)

Abstract

Background From the results of a previous study, it remained to be investigated if a perioperative rise of few tested coagulation and inflammation markers is caused by conventional cardiopulmonary bypass (CPB) itself or rather by direct recirculation of pericardial fluids.

Methods Forty-eight patients operated on with conventional CPB for myocardial revascularization were randomized either for direct recirculation of pericardial suction fluids or for cell saving (CS).

Results Thrombin–antithrombin complexes showed lower values intraoperatively in the CS group (p < 0.0001), and D-dimers tended to remain lower at intensive care unit arrival (p = 0.095). Tests of inflammation markers were less meaningful.

Conclusion Direct recirculation of pericardial fluids rather than conventional CPB itself causes major intraoperative changes of some coagulation markers. Pericardial blood loss with direct recirculation should be kept to a minimum to avoid unnecessary activation of coagulation. Inflammation markers need further investigations.

Note

This article was presented as a poster at the 46th annual meeting of the German Society for Thoracic and Cardiovascular Surgery in February 2017, Leipzig, Germany.