Cardiopulmonary bypass and dual antiplatelet therapy: a strategy to minimise transfusions and blood loss

Perfusion (United Kingdom)

Volumn 35, Issue 3, 2020, Pages 236-245

  Karlsson, Mattias ^a   Hannuksela, Matias ^a   Appelblad, Micael ^a   Hällgren, Oskar ^a   Johagen, Daniel ^a   Wahba, Alexander ^b   Svenmarker, Staffan ^a  

^a UMEÅ UNIVERSITY   (Sweden)

^b NORWEGIAN UNIVERSITY OF SCIENCE AND TECHNOLOGY   (Norway)

Author keywords

blood loss; cardiopulmonary bypass; platelet inhibitors

Indexed keywords

ACETYLSALICYLIC ACID; ADENOSINE DIPHOSPHATE; HEMOGLOBIN; HEPARIN; TICAGRELOR; ANTITHROMBOCYTIC AGENT;

ADULT; ARTICLE; BLOOD CLOTTING TIME; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; DRUG WITHDRAWAL; DUAL ANTIPLATELET THERAPY; ERYTHROCYTE CONCENTRATE; FEMALE; GRAFT SALVAGE; HOSPITAL ADMISSION; HUMAN; INHIBITION KINETICS; INTRAOPERATIVE PERIOD; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; POSTOPERATIVE HEMORRHAGE; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; RISK REDUCTION; THROMBOCYTE FUNCTION; THROMBOELASTOMETRY; VOLUME; AGED; PROCEDURES;

AGED; CARDIOPULMONARY BYPASS; FEMALE; HUMANS; MALE; MIDDLE AGED; PLATELET AGGREGATION INHIBITORS;

EID: 85071554803     PISSN: 02676591     EISSN: 1477111X     Source Type: Journal    
DOI: 10.1177/0267659119867005     Document Type: Article

References (29)

1. Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 2018; 391: 939–948.
2. Hansson EC, Jideus L, Aberg B, et al. Coronary artery bypass grafting-related bleeding complications in patients treated with ticagrelor or clopidogrel: a nationwide study. Eur Heart J 2016; 37: 189–197.
3. Nagashima Z, Tsukahara K, Uchida K, et al. Impact of preoperative dual antiplatelet therapy on bleeding complications in patients with acute coronary syndromes who undergo urgent coronary artery bypass grafting. J Cardiol 2016; 69: 156–161.
4. Cayla G, Collet JP, Silvain J, et al. Pretreatment with P2Y12 inhibitors in non-ST-segment elevation acute coronary syndrome: time to revise the guidelines? Arch Cardiovasc Dis 2014; 107: 1–3.
5. Valgimigli M., The ESC DAPT guidelines 2017. Eur Heart J 2018; 39: 187–188.
6. O’Connor SA, Amour J, Mercadier A, et al. Efficacy of ex vivo autologous and in vivo platelet transfusion in the reversal of P2Y12 inhibition by clopidogrel, prasugrel, and ticagrelor: the APTITUDE study. Circ Cardiovasc Interv 2015; 8: e002786.
7. Calmette L, Martin AC, Le Bonniec B, et al. Ticagrelor reversal: in vitro assessment of four haemostatic agents. J Clin Pathol 2017; 70: 733–739.
8. Kirklin JK, Westaby S, Blackstone EH, et al. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983; 86: 845–857.
9. Punjabi PP, Taylor KM., The science and practice of cardiopulmonary bypass: from cross circulation to ECMO and SIRS. Glob Cardiol Sci Pract 2013; 2013: 249–260.
10. Westerberg M, Gabel J, Bengtsson A, et al. Hemodynamic effects of cardiotomy suction blood. J Thorac Cardiovasc Surg 2006; 131: 1352–1357.
11. Gabel J, Malm CJ, Radulovic V, et al. Cell saver processing mitigates the negative effects of wound blood on platelet function. Acta Anaesthesiol Scand 2016; 60: 901–909.
12. Niranjan G, Asimakopoulos G, Karagounis A, et al. Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial. Eur J Cardiothorac Surg 2006; 30: 271–277.
13. Bagge L, Thelin S, Hultman J, et al. Heparin-coated CPB-sets increase biocompatibility and reduce endothelial cell damage in pigs. J Cardiothorac Anesth 1989; 3: 84.
14. Mahmood S, Bilal H, Zaman M, et al. Is a fully heparin-bonded cardiopulmonary bypass circuit superior to a standard cardiopulmonary bypass circuit? Interact Cardiovasc Thorac Surg 2012; 14: 406–414.
15. Elgue G, Blomback M, Olsson P, et al. On the mechanism of coagulation inhibition on surfaces with end point immobilized heparin. Thromb Haemost 1993; 70: 289–293.
16. Olsson A, Alfredsson J, Ramstrom S, et al. Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer’s chase technique – a randomized pilot study. Perfusion 2018; 33: 185–193.
17. Whiting D, DiNardo JA., TEG and ROTEM: technology and clinical applications. Am J Hematol 2014; 89: 228–232.
18. Ranucci M, Baryshnikova E, Crapelli GB, et al. Electric impedance platelet aggregometry in cardiac surgery patients: a comparative study of two technologies. Platelets 2016; 27: 185–190.
19. Mehran R, Rao SV, Bhatt DL, et al. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation 2011; 123: 2736–2747.
20. Sousa-Uva M, Head SJ, Milojevic M, et al. 2017 EACTS guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg 2018; 53: 5–33.
21. Hansson EC, Malm CJ, Hesse C, et al. Platelet function recovery after ticagrelor withdrawal in patients awaiting urgent coronary surgery. Eur J Cardiothorac Surg 2017; 51: 633–637.
22. Storey RF, Bliden KP, Ecob R, et al. Earlier recovery of platelet function after discontinuation of treatment with ticagrelor compared with clopidogrel in patients with high antiplatelet responses. J Thromb Haemost 2011; 9: 1730–1737.
23. Shirota K, Watanabe T, Takagi Y, et al. Maintenance of blood heparin concentration rather than activated clotting time better preserves the coagulation system in hypothermic cardiopulmonary bypass. Artif Organs 2000; 24: 49–56.
24. Ovrum E, Tangen G, Tollofsrud S, et al. Heparinized cardiopulmonary bypass circuits and low systemic anticoagulation: an analysis of nearly 6000 patients undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg 2011; 141: 1145–1149.
25. Meesters MI, Veerhoek D, de Lange F, et al. Effect of high or low protamine dosing on postoperative bleeding following heparin anticoagulation in cardiac surgery. A randomised clinical trial. Thromb Haemost 2016; 116: 251–261.
26. Packham MA., The behavior of platelets at foreign surfaces. Proc Soc Exp Biol Med 1988; 189: 261–274.
27. Aldea GS, Soltow LO, Chandler WL, et al. Limitation of thrombin generation, platelet activation, and inflammation by elimination of cardiotomy suction in patients undergoing coronary artery bypass grafting treated with heparin-bonded circuits. J Thorac Cardiovasc Surg 2002; 123: 742–755.
28. Shiiya N, Matsuzaki K, Kunihara T, et al. Heparin reduction with the use of cardiotomy suction is associated with hyperfibrinolysis during distal aortic perfusion with a heparin-coated semi-closed cardiopulmonary bypass system. J Artif Organs 2006; 9: 214–219.
29. Pagano D, Milojevic M, Meesters MI, et al. 2017 EACTS/EACTA guidelines on patient blood management for adult cardiac surgery. Eur J Cardiothorac Surg 2018; 53: 79–111.