Factors associated with excessive bleeding in cardiopulmonary bypass patients: a nested case-control study
| العنوان: | Factors associated with excessive bleeding in cardiopulmonary bypass patients: a nested case-control study |
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| المؤلفون: | José Luis Iribarren, Rafael Martínez, Ysamar Barrios, María de la Luz Mora, M Brouard, José M. Lorenzo, Leonardo Lorente, José María Raya, Pilar Garrido, Juan J Jimenez Rivera, R Perez, Blas Alarco, Ibrahim Nassar, Maribel Diaz |
| المصدر: | Journal of Cardiothoracic Surgery, Vol 2, Iss 1, p 17 (2007) Journal of Cardiothoracic Surgery |
| بيانات النشر: | BMC, 2007. |
| سنة النشر: | 2007 |
| مصطلحات موضوعية: | Excessive Bleeding, Leptin, Male, medicine.medical_treatment, Severity of Illness Index, law.invention, law, Hospital Mortality, Cardiopulmonary Bypass, Fibrinolysis, General Medicine, Complement C3, Middle Aged, Cardiac surgery, Intensive Care Units, Bypass surgery, Cardiothoracic surgery, Anesthesia, Female, Cardiology and Cardiovascular Medicine, Research Article, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Antifibrinolytic, medicine.drug_class, lcsh:Surgery, Enzyme-Linked Immunosorbent Assay, Postoperative Hemorrhage, Risk Assessment, Statistics, Nonparametric, lcsh:RD78.3-87.3, Plasminogen Activator Inhibitor 1, Preoperative Care, medicine, Cardiopulmonary bypass, Humans, Blood Coagulation, Aged, Probability, Postoperative Care, business.industry, lcsh:RD1-811, Survival Analysis, Surgery, Logistic Models, lcsh:Anesthesiology, Case-Control Studies, Nested case-control study, Multivariate Analysis, business, Blood Chemical Analysis, Follow-Up Studies |
| الوصف: | IntroductionExcessive bleeding (EB) after cardiopulmonary bypass (CPB) may lead to increased mortality, morbidity, transfusion requirements and re-intervention. Less than 50% of patients undergoing re-intervention exhibit surgical sources of bleeding. We studied clinical and genetic factors associated with EB.MethodsWe performed a nested case-control study of 26 patients who did not receive antifibrinolytic prophylaxis. Variables were collected preoperatively, at intensive care unit (ICU) admission, at 4 and 24 hours post-CPB. EB was defined as 24-hour blood loss of >1 l post-CPB. Associations of EB with genetic, demographic, and clinical factors were analyzed, using SPSS-12.2 for statistical purposes.ResultsEB incidence was 50%, associated with body mass index (BMI)< 26.4 (25–28) Kg/m2, (P= 0.03), lower preoperative levels of plasminogen activator inhibitor-1 (PAI-1) (P= 0.01), lower body temperature during CPB (P= 0.037) and at ICU admission (P= 0.029), and internal mammary artery graft (P= 0.03) in bypass surgery. We found a significant association between EB and 5G homozygotes for PAI-1, after adjusting for BMI (F = 6.07;P= 0.02) and temperature during CPB (F = 8.84;P= 0.007). EB patients showed higher consumption of complement, coagulation, fibrinolysis and hemoderivatives, with significantly lower leptin levels at all postoperative time points (P= 0.01,P< 0.01 andP< 0.01).ConclusionExcessive postoperative bleeding in CPB patients was associated with demographics, particularly less pronounced BMI, and surgical factors together with serine protease activation. |
| اللغة: | English |
| تدمد: | 1749-8090 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eeed080de800a75080a8f03a548aad15Test http://www.cardiothoracicsurgery.org/content/2/1/17Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....eeed080de800a75080a8f03a548aad15 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17498090 |
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