Haemostasis Disorders after an Extra-Corporeal Circulation in Cardiac Surgery, Based on a Study of 850 Patients

The purpose of the study was to determine the influence of Extra-Corporeal Circulation (E.C.C.) on the principal factors of haemostasis, then to define biological troubles with a view their prevention. Tests performed 25 minutes after the conclusion of E.C.C., neutralization of heparin by protamin, Kunitz inhibitor injection, produced the following results: platelet count 75795 + 22045/mm3, prothrombin value 60.81±10.97%, fibrinogen 2.06 ± 0.85 g/1; the euglobulin lysis time was positive within 30 minutes for 1.16% of the patients;an heparinaemia lower than 0.2 Ul/ml was found in 69.41 % of the cases when the E.C.C. was performed in conditions of moderate hypothermia (28°c) and in 41.81% in deep hypothermia. A further injection of protamin was given in all cases where the heparinaemia was found to be above 0.2 UI/ml. A new control reading was made 3 hours later and showed an heparin rebound in 34.05% of the cases. These results allowed us to fomulate a standard monitoring program in case of post-operative bleeding.