Does hemodilution by the crystalloid priming solution derange the efficacy of anticoagulation during cardiopulmonary bypass?

GROUND AND AIM: Recent studies suggest the development of a procoagulant state with hemodilution. We conducted this study to investigate the effect of hemodilution, by the priming solution in a cardiopulmonary bypass (CPB) circuit, on "point of care" coagulation assays (activated clotting time ACT and thromboelastography TEG). METHODS: Twenty patients undergoing cardiac surgery with crystalloid priming of CPB circuit were evaluated.

Confounding variables arising from contact activation were eliminated by minor modifications. Ten milliliter per kilogram body weight of priming solution (lactated Ringer's) was infused via the aortic cannula. ACT and TEG were performed, both prior to and immediately after hemodilution.

In case of latter, four variables, reaction time (r), coagulation time (k), maximum amplitude (MA), and clot formation rate (angle alpha), were estimated and considered for the results. To see if these results are duplicated "in vitro," prebypass blood samples from ... more.

I cant really gove you an answer,but what I can give you is a way to a solution, that is you have to find the anglde that you relate to or peaks your interest. A good paper is one that people get drawn into because it reaches them ln some way.As for me WW11 to me, I think of the holocaust and the effect it had on the survivors, their families and those who stood by and did nothing until it was too late.