Crosstalk between inflammation and coagulation: erythrocyte rheology during cardiac surgery with cardiopulmonary bypass

2016 Fiscal Year Final Research Report

• Project/Area Number: 26462373
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: Ichikawa Junko 東京女子医科大学, 医学部, 講師 (60318144)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 赤血球流動挙動 / 血液凝固機能 / 体外循環 / 心臓手術

Outline of Final Research Achievements

The present study showed that echinocytosis is induced without significant loss of deformability at the start of cardiopulmonary bypass (CPB). Loss of deformability did not occur in parallel with the morphological changes after initiation of CPB, but it was associated with administration of homologous blood at the end of CPB and the stored red blood cells themselves, accompanied by significantly smaller MCV and larger MCHC. After initiation of CPB and despite adequate anticoagulation with heparin, the F1+2 and TAT complex significantly increased compared with baseline. Thrombin formation at CPB initiation and the prolonged clotting lag time depending on the heparin concertation may lead to an underestimation of the fibrinogen level by the PT-derived method. Timely availability of ROTEM-based coagulation management during cardiac surgery has the potential to reduce overall blood product use and blood loss and the duration of hospitalization compared with empirical treatment.

Free Research Field

麻酔学