DelRossi A J, Cernaianu A C, Vertrees R A, Fuller S J, Costabile J, Yu Y, Cilley J H, Baldino W A
Department of Surgery, Cooper Hospital/University Medical Center, Camden, NJ 08103.
J Trauma. 1990 Jan;30(1):79-82. doi: 10.1097/00005373-199001000-00012.
In an attempt to assess the changes occurring to the coagulation profile during internal active core rewarming with partial cardiopulmonary bypass (CPB) without heparin anticoagulation, five pigs were anesthetized, and a model for severe to moderate hypothermia was created. Femoral-femoral bypass with Bio-Pump, heat exchanger, and a membrane oxygenator were used during the rewarming for 64.8 +/- 8.5 minutes. There were no statistically significant changes in platelet count, platelet index, activated clotting time (ACT), partial thromboplastin time (PTT), prothrombin time (PT), fibrinogen, fibrinogen index and fibrin split products (p greater than 0.05). There were no thromboembolic sequelae seen at autopsy. The components of the CPB circuit showed no signs of formation of aggregates or thrombi. The results of this study are attributed to the nonthrombogenic, atraumatic design of the Bio-Pump and the enhanced physiological fibrinolysis seen in the first hour of CPB. We concluded that heparinless CPB may serve as a safe alternative for active core rewarming for severe to moderate hypothermia.
为了评估在部分体外循环（CPB）且无肝素抗凝的情况下进行体内主动核心复温时凝血谱的变化，对5头猪进行麻醉，并建立了重度至中度低温模型。在复温过程中使用Bio-Pump、热交换器和膜式氧合器进行股-股旁路循环64.8±8.5分钟。血小板计数、血小板指数、活化凝血时间（ACT）、部分凝血活酶时间（PTT）、凝血酶原时间（PT）、纤维蛋白原、纤维蛋白原指数和纤维蛋白降解产物均无统计学显著变化（p＞0.05）。尸检未见血栓栓塞后遗症。CPB回路的组件未显示形成聚集体或血栓的迹象。本研究结果归因于Bio-Pump的非血栓形成、无创伤设计以及CPB第一小时内增强的生理性纤维蛋白溶解。我们得出结论，无肝素CPB可作为重度至中度低温主动核心复温的安全替代方法。
