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Thorac Cardiovasc Surg 2021; 69(08): 719-722
DOI: 10.1055/s-0040-1721477
Short Communication

Effect of Prolonged Hypothermic Cardiopulmonary Bypass, Heparin, and Protamine on Platelet: A Small-Group Study

Danny Epstein 
1   Department of Internal Medicine “B,” Rambam Health Care Campus, Haifa, Israel
,
Andrey Vishnepolsky
2   Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel
,
Gil Bolotin
3   Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel
4   Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
,
Nardeen Atweh
5   Blood Bank and Platelet Immunology Laboratories, Rambam Health Care Campus, Haifa, Israel
,
Lilach Bonstein
4   Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
5   Blood Bank and Platelet Immunology Laboratories, Rambam Health Care Campus, Haifa, Israel
,
Amit Lehavi
2   Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel
4   Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
› Author Affiliations Funding Rambam-Ofakim Research Program.
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Abstract

Cardiopulmonary bypass (CPB) is associated with platelet dysfunction (PD), an important cause of postoperative bleeding. The etiology of PD is not completely understood. We mapped the platelets' function during CPB to determine the etiology of PD. Platelets activation, measured by procaspase activating compound-1 and P-selectin expression (CD62P), after activation by adenosine diphosphate and thrombin receptor activator peptide, were decreased by protamine. Changes during CPB were insignificant. Platelet-leukocyte aggregation was increased by CPB but not by protamine. Platelet apoptosis marker, annexin V, was increased by protamine. Changes during CPB were insignificant. Our findings demonstrate that protamine given after CPB plays a central role in PD and count decrease.

Keywords

cardiopulmonary bypass (CPB) - blood - coagulation/anticoagulation - hematology - anesthesia (includes related subject matter)

Supplementary Material



Publication History

Received: 07 September 2020

Accepted: 19 October 2020

Article published online:
19 January 2021

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