Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jul 1997
ReviewCoagulation disturbance in profound hypothermia: the influence of anti-fibrinolytic therapy.
Extensive thoracic aortic resections often require a period of profoundly hypothermic circulatory arrest. The extent of surgical dissection, damaging effects of cardiopulmonary bypass, and coagulation disturbances of hypothermia predispose to bleeding. ⋯ Pharmacological antifibrinolytic therapy with aprotinin or other agents has been shown to preserve hemostasis, but the efficacy of antifibrinolytic therapy remains unproven in thoracic aortic operations with hypothermic circulatory arrest. This report discusses the interactions of hypothermia with the coagulation system, together with the efficacy of fibrinolytic therapy from existing surgical experience.