Thromb Haemost 2005; 93(06): 1101-1107
DOI: 10.1160/TH04-12-0799
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Relationship between factor XIII activity, fibrinogen, haemostasis screening tests and postoperative bleeding in cardiopulmonary bypass surgery

Markus Blome
1   Clinic for Cardiac Surgery, Institute of Hemostaseology
,
Frank Isgro
1   Clinic for Cardiac Surgery, Institute of Hemostaseology
,
Arndt Holger Kiessling
1   Clinic for Cardiac Surgery, Institute of Hemostaseology
,
Jan Skuras
1   Clinic for Cardiac Surgery, Institute of Hemostaseology
,
Hannelore Haubelt
2   Transfusion Medicine, Academic City Hospital, Ludwigshafen/Germany
,
Peter Hellstern
2   Transfusion Medicine, Academic City Hospital, Ludwigshafen/Germany
,
Werner Saggau
1   Clinic for Cardiac Surgery, Institute of Hemostaseology
› Author Affiliations
Further Information

Publication History

Received 14 December 2004

Accepted after resubmission 02 March 2005

Publication Date:
11 December 2017 (online)

Summary

We investigated the relationship between factor XIII, fibrinogen, blood coagulation screening tests and postoperative bleeding in 98 patients undergoing cardiopulmonary bypass (CPB) surgery. All patients received aprotinin. Blood samples were collected preoperatively (T1), after termination of CPB (T2), 12 h (T3) and 24 h (T4) after surgery to determine FXIII activity, fibrinogen, platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimers (DD). Laboratory results were correlated with the chest tube drainage 24 h after surgery and compared between patients with 24-hour chest tube drain volumes in the lower (Group 1) with those in the upper tertile (Group 3). Median FXIII and fibrinogen levels dropped by 33.9% and 34.2%, respectively, during CPB. No association between FXIII activity and the extent of postoperative bleeding was found. However, chest tube bleeding was significantly correlated with preoperative and postoperative fibrinogen. This was confirmed by comparing Groups 1 and 3. Group 3 patients had significantly lower fibrinogen levels than Group 1 at T1 – T4, although most fibrinogen values were within or above the reference range (medians, g/l: 3.5 vs. 4.0, p = 0.043 at T1; 2.3 vs. 2.7, p = 0.015 at T2; 2.9 vs. 3.3, p = 0.008 at T3; 4.2 vs. 5.2, p = 0.002 at T4). There was also a significant relationship of platelet count, PT and APTT, as measured after CPB (T2), with postoperative chest tube drainage. In conclusion, plasma FXIII activity does not influence postoperative bleeding in patients undergoing CPB surgery. There is however an inverse association between preoperative or postoperative plasma fibrinogen levels and postoperative bleeding. These findings indicate a modulation of postoperative bleeding by fibrinogen levels.

 
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