title: Hemostatic parameters and platelet activation marker expression in cyanotic and acyanotic pediatric patients undergoing cardiac surgery in the presence of tranexamic acid.
abstract: We have investigated hemostatic parameters including platelet activation in 56 pediatric patients with or without cyanosis undergoing cardiopulmonary bypass (CPB) and cardiac surgery to repair congenital defects. Patients were participants in a study assessing the effects of tranexamic acid on surgery-related blood loss. Parameters monitored included blood loss, prothrombin F1.2, thrombin-antithrombin complexes, t-PA, PAI-1, plasminogen, fibrin D-dimer, and plasma factor XIII. Additionally, flow cytometry monitored platelet degranulation (P-selectin or CD63), as well as surface-bound fibrinogen, von Willebrand factor and factor XIIIa. Cyanotic patients had evidence of supranormal coagulation activation as both fibrin D-dimer and PAI-1 levels were elevated prior to surgery. While the extent of expression of P-selectin or CD63 was not informative, platelet-associated factor XIIIa was elevated in cyanotic patients at baseline. In both patient groups, CPB altered platelet activation state and coagulation status irrespective of the use of tranexamic acid.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Levin
authors.forename: J
authors.initials: J
authors.lastname: Wu
authors.forename: D V
authors.initials: DV
authors.lastname: Devine
authors.forename: J
authors.initials: J
authors.lastname: Alexander
authors.forename: C
authors.initials: C
authors.lastname: Reichart
authors.forename: S
authors.initials: S
authors.lastname: Sett
authors.forename: M
authors.initials: M
authors.lastname: Seear
mesh_terms: D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D003490:Cyanosis; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006487:Hemostasis; D006801:Humans; D007223:Infant; D008297:Male; D015539:Platelet Activation; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid