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.
Keywords
blood - coagulation - anticoagulation - cardiopulmonary bypass - CPB - coronary artery
bypass grafting - surgery - CABG
