Hematologic Problems Associated With the Use of Extracorporeal Circulation for Cardiovascular Surgery

Article1 November 1958HEMATOLOGIC PROBLEMS ASSOCIATED WITH THE USE OF EXTRACORPOREAL CIRCULATION FOR CARDIOVASCULAR SURGERYIVAN W. BROWN JR., M.D., WIRT W. SMITH, M.D.IVAN W. BROWN JR., M.D., WIRT W. SMITH, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-49-5-1035 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExtracorporeal circulation maintained by an artificial heart-lung apparatus is now an essential and established procedure for certain types of cardiovascular surgery. With this new development has come a host of special blood problems that covers a wide spectrum of hematology from coagulation to blood banking technics.Fortunately, a large number of these problems have been or are being solved, so that in the last two years the use of extracorporeal circulation has become relatively safe and is being employed in a large number of medical centers in this country and abroad.Up to the present time, extracorporeal circulation is still...Bibliography1. JonesDonaldSwanHarshbargerKirklinWood REDEHJHGJWEH: Apparatus of the Gibbon type for mechanical by-pass of the heart and lungs; preliminary report, Proc. Staff Meet., Mayo Clin. 30: 105, 1955. MedlineGoogle Scholar2. KayGaertner JHRA: A simplified pump oxygenator with flow equal to normal cardiac output, S. Forum 7: 267, 1956. Google Scholar3. Melrose DG: A mechanical heart-lung for use in man, Brit. M. J. 2: 57, 1953. CrossrefMedlineGoogle Scholar4. MorrowGilbertSharpRossWeldon AGJWEJCS: Experimental use of the Melrose pump-oxygenator, Tr. Am. Soc. Art. Int. Org. 3: 46, 1957. Google Scholar5. NewmanStuckeyLevowitzYoungDennisFriesGorayebZuhdiCarlsonAdlerGliedman MNJHBSLACCEJMKSM: Complete and partial perfusion of animal and human subjects with the pump-oxygenator, Surgery 38: 30, 1955. MedlineGoogle Scholar6. LilleheiDeWallReadWardenVarco CWRARCHERL: Direct vision intracardiac surgery in man using a simple disposable artificial oxygenator, Dis. of Chest 24: 1, 1956. Google Scholar7. ClowesNeville GHWE: Further development of a blood oxygenator dependent upon the diffusion of gases through plastic membranes, Tr. Am. Soc. Art. Int. Org. 3: 52, 1957. Google Scholar8. OsbornMackenzieShawPerkinsHurtGerbode JJRAHRF: Cause and prevention of hemorrhage following extracorporeal circulation, S. Forum 6: 96, 1955. Google Scholar9. Allen JG: Problems and questions on coagulation of blood arising from the use of extracorporeal circulation pumps and oxygenators, National Institutes of Health Conference on Problems of Extracorporeal Circulation, Chicago, Ill., Sept., 1957, to be published. Google Scholar10. PerkinsOsbornGerbode HAJJF: Blood coagulation problems associated with extracorporeal circulation, presented at National Research Council Conference on Blood Problems in Extracorporeal Circulations and Massive Transfusions, Washington, D. C., Feb., 1958, to be published. Google Scholar11. SmithBrown WWIW: Unpublished observations. Google Scholar12. PenickAverettePeters GDHER: Some responses of canine clotting factors to extracorporeal circulation, presented at National Research Council Conference on Blood Problems in Extracorporeal Circulations and Massive Transfusions, Washington, D. C., Feb., 1958, to be published. Google Scholar13. TroupReed SBCF: Platelet thromboplastic factor: its chemical nature, in vitro activity, and the identification of similar thromboplastic substances in red blood cells, J. Clin. Investigation, in press. Google Scholar14. MelroseBassettBeaconsfieldGraberShackman DGJWPIGR: Experimental physiology of a heart-lung machine in parallel with normal circulation, Brit. M. J. 2: 62, 1953. CrossrefMedlineGoogle Scholar15. De WallWardenMelbyMinotVarcoLillehei RAHEJCHRLCW: Physiological responses during total body perfusion with a pump-oxygenator, J. A. M. A. 165: 1788, 1957. CrossrefMedlineGoogle Scholar16. McCaughanMcMichaelSchuderKirby JSHJCCK: An experimental study of hemolysis caused by various pump-oxygenator components with emphasis on the comparative advantages and hemolytic effects of occlusive and non-occlusive pumps, presented at the Society of University Surgeons, Boston, Mass., Feb., 1958, Surgery, in press. Google Scholar17. BrownSmithEmmons IWWWWO: An efficient blood heat exchanger for use with extracorporeal circulation, Surgery, in press. Google Scholar18. Cooley DA: Discussion of papers on the effects of perfusion on the blood, National Institutes of Health Conference on Problems of Extracorporeal Circulation, Chicago, Ill., Sept., 1957, to be published. Google Scholar19. HewittBrownEadieSmithSealy WCIWGSWWWC: The ultimate in vivo survival of erythrocytes which have circulated through a pump-oxygenator, S. Forum 7: 271, 1957. MedlineGoogle Scholar20. AdnerSjölin PLS: Unexpected blood group incompatibility revealed by Cr51 labelled red cells, Scandinav. J. Clin. and Lab. Invest. 9: 265, 1957. CrossrefMedlineGoogle Scholar21. EadieBrownSmith GSIWWW: Unpublished observations. Google Scholar22. Ringer S: A further contribution regarding the influence of the different constituents of the blood on the contraction of the heart, J. Physiol. 4: 29, 1883. CrossrefMedlineGoogle Scholar23. CarterAndrus EPEC: QT interval in human electrocardiogram in the absence of cardiac disease, J. A. M. A. 78: 1922, 1922. Google Scholar24. WhiteMudd PDSG: Observations on the effect of various factors on the duration of the electrical systole of the heart as indicated by the Q-T interval of the electrocardiogram, J. Clin. Investigation 7: 387, 1929. CrossrefMedlineGoogle Scholar25. ErnsteneProudfit ACWL: Differentiation of the changes in the Q-T interval in hypocalcemia and hypopotassemia, Am. Heart J. 38: 260, 1949. CrossrefMedlineGoogle Scholar26. FurmanHellersteinStartzman RAHKVV: Electrocardiographic changes occurring during the course of replacement transfusions, J. Pediat. 38: 45, 1951. CrossrefMedlineGoogle Scholar27. GrumbachHowardMerrill LJWVI: Factors related to the initiation of ventricular fibrillation in the isolated heart: effect of calcium and potassium, Circul. Res. 2: 452, 1954. CrossrefMedlineGoogle Scholar28. BechtelWhiteEstes JTJEHE: The electrocardiographic effects of hypocalcemia induced in normal subjects with Edathamil disodium, Circulation 13: 837, 1956. CrossrefMedlineGoogle Scholar29. Garb S: The effects of potassium, ammonium, calcium, strontium, and magnesium on the electrogram and myogram of mammalian heart muscle, J. Pharmacol. and Exper. Therap. 101: 317, 1951. MedlineGoogle Scholar30. HubbardNeisBarmore TFDDJL: Severe citrate intoxication during cardiovascular surgery, J. A. M. A. 162: 1534, 1956. CrossrefMedlineGoogle Scholar31. CooksonCostas-DurieuxBailey BAJCP: Toxic effects of citrated blood and the search for suitable substitute for use in cardiac surgery, Ann. Surg. 139: 430, 1954. CrossrefMedlineGoogle Scholar32. SmithBrown WWIW: A new anticoagulant-preservative solution for donor blood for use in extracorporeal circulation, presented at National Research Council Conference on Blood Problems in Extracorporeal Circulations and Massive Transfusions, Washington, D. C., Feb., 1958, to be published. Google Scholar33. ZuckerBorrelli MBJ: Correction of defects in EDTA blood by magnesium and other divalent cations, J. Appl. Physiol., in press. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Durham, North Carolina*Presented at the Thirty-ninth Annual Session of The American College of Physicians, Atlantic City, New Jersey, April 29, 1958.From the Department of Surgery, Duke University School of Medicine, Durham, North Carolina.†Certain studies from the authors' laboratory mentioned in this paper were supported in part by a research grant from the National Heart Institute, U. S. Public Health Service (H-1226).Requests for reprints should be addressed to Ivan W. Brown, Jr., M.D., Duke University Medical Center, Durham, North Carolina. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRed Cell Incompatibility in VivoThe haemostatic defect following extracorporeal circulationChanges in blood-coagulation due to perfusion for cardiac surgeryOff-pump coronary artery bypass surgeryThe history of the concept of inflammatory responses to cardiopulmonary bypassCardiopulmonary bypass inflammatory and immunologic phenomenaIrregular Isoantibodies in the Sera of Patients Undergoing Chronic HemodialysisFibrinolysis and Disseminated Intravascular Coagulation in Open Heart SurgeryPlatelet support for cardiopulmonary bypass surgeryEvaluation of a Microcrystalline Bovine Collagen Hemostatic Agent in Canine Solid Viscera Injury Using Abdominal Impedance PlethysmographyUse of Laboratory Animals in Artificial Organ ResearchAlloantibodies and Australia antigen after open heart surgeryA Study of Platelet Counts During Cardiopulmonary BypassEpsilon-Aminocaproic Acid for Bleeding After Cardiopulmonary BypassTHE EFFECT OF ISOANTIBODIES ON RED-CELL SURVIVALCoagulation Defects and Bleeding in Open-Heart SurgeryA technique for the use of autologous fresh blood during open-heart surgeryAutomated Differential Agglutination Technic to Measure Red Cell SurvivalEmergency Reoperation Following Open-Heart SurgeryPROBLEMS IN HEMOSTASIS WITH EXTRACORPOREAL APPARATUSAN ANALYSIS OF AVERAGE EVOKED POTENTIALS MAKING USE OF LEAST MEAN SQUARE TECHNIQUES*Some aspects of haemostasis after open-heart surgeryImmunization after Intravenous Injection of Small Amounts of 51 Cr-Labelled Red CellsThe Fractionation of Heparinized BloodClinical pathologic conferenceFragen der Blutgerinnung bei extrakorporalem Kreislauf mit der Herz-Lungen-MaschineBluttransfusion 1 November 1958Volume 49, Issue 5Page: 1035-1048KeywordsBlood banksCardiac surgeryHeartHematology and oncologyLongitudinal studiesMagnesiumMedical servicesResearch grantsResearch laboratoriesSurgery ePublished: 1 December 2008 Issue Published: 1 November 1958 PDF downloadLoading ...