Research ArticleeOpen Access

Platelet Function during Platelet-Rich Plasma Sequestration in Complex Cardiac Surgical Procedures - Prospective Controlled Study

Volume 6 - Issue 2

**Slavik L*¹ ,Hajek R²,Chaloupkova P¹, Ulehlova J¹ and Lonsky V²**

Author Information Open or Close
- ¹Department of Hemato-Oncology Faculty of Medicine and Dentistry Palacky University Olomouc and University Hospital Olomouc
- ²Department of Cardiac Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc; University Hospital Olomouc
*Corresponding author: Luděk Slavík, Department of Cardiac Surgery, Republic of Czech

Received: June 18, 2018; Published: June 28, 2018

DOI: 10.26717/BJSTR.2018.06.001317

Full Text PDF

To view the Full Article Peer-reviewed Article PDF

Abstract

Cardiopulmonary bypass (CPB) is associated with common activation of all four integral components of hemostasis, that is, the endothelium, plasma proteins, platelets and fibrinolysis. The causative factors include the presence of an artificial non-endothelial surface of the CPB system, non-pulsatile blood flow, hemodilution, hypothermia, surgical trauma and a systemic inflammatory response to CPB. Microthrombi formation, coagulation defects and hypercoagulability in the postoperative period may occur. The key pathway of activation is platelet binding to collagen via von Willebrand factor, platelet activation and aggregation and formation of an initial hemostatic plug. Thrombin generation (tF+fVIIa →fIXa →fXa →prothrombin →thrombin) activates platelets, fV, fVIII and fXI. Fibrinogen and fXIII stabilize the clot.

Keywords: Fibrinolysis; Hypothermia; Hypercoagulability; Non-Pulsatile; Hemostasis; Hemodilution; Trauma; Coagulation; Thrombocytopenia; Hemostatic Plug

Abbreviations: CPB: Cardiopulmonary Bypass; PRP: Platelet Rich Plasma; UFH: Unfractionated Heparin; ACT: Activated Coagulation Time; RBC: Red Blood Cell; TEG: Thrombo Elasto Graphy; LTA: Light Transmission Aggregometry; PPP: Platelet Poor Plasma