[Hemostatic changes in children treated with heart surgery with cardiopulmonary bypass].
OBJECTIVE
We evaluated hemostasic changes in children undergoing open heart surgery with cardiopulmonary bypass (CPB).


METHODS
We studied 17 children before, during surgery, in the immediate, first and between the 4th and 7th postoperative days, measuring hematocrit, prothrombin time, activated partial thromboplastin time, fibrinogen, platelet count, factor V and euglobulin lysis time. Children were divided in those with and without excessive bleeding in the postoperative period.


RESULTS
We observed significant prolongation of prothrombin time and activated partial thromboplastin time, reduction of fibrinogen and factor V, and shortening of euglobulin lysis time. Six (35%) children bled excessively. Platelet count reduction was greater in the intra operative period in these cases and the duration of CPB was longer in this group.


CONCLUSIONS
Changes in hemostasis during open heart surgery are due to coagulation cascade disorders as well as fibrinolysis. The incidence of excessive bleeding is higher in the pediatric group. Prolonged CPB time and greater reduction in platelet count differentiated both groups.
Silveira
F M
FM
Escola Paulista de Medicina, Universidade Federal de São Paulo.
Lourenço
D M
DM
Maluf
M
M
Carvalho
W B
WB
Buffolo
E
E
Carvalho
A C
AC
D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D005260:Female; D006403:Hematologic Tests; D006470:Hemorrhage; D006487:Hemostasis; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies
Alterações da hemostasia em crianças submetidas a cirurgia cardíaca com circulação extracorpórea.