title: Soluble fibrin monomer complex and cardiopulmonary bypass.
abstract: Soluble fibrin monomer complexes (SFMCs) are precursors of fibrin polymer formation. Laboratory tests can be used to detect SFMCs in plasma. The purpose of this study was to determine whether a positive SFMC test is associated with pre-operative, intra-operative, and post-operative variables for patients that have undergone cardiopulmonary bypass (CPB). Pre-operative, operative, post-operative, and laboratory data from 120 consecutive adults patients (July 3, 2006 to June 29, 2007) that had undergone cardiac surgery with the use of CPB were obtained from a prospective quality control database. Two groups were created. Group 1 was all negative (NEG). This group had no SFMC test with a positive result (n=60) and no positive SFMCs (POS, n=60). Group 2 was any positive (POS). This group had at least one positive SFMC test (n=60). The POS group had more patients with endocarditis (11.7% vs. 3.3%, p < .001), chronic obstructive pulmonary disease (COPD) (18% vs. 8.3%, p = .005), longer CPB time (172 +/- 64 vs. 151 +/- 53 minutes, p = .047), and fewer minimally invasive procedures (31.7% vs. 51.7%, p = .002). The POS group required intraoperative (70.0% vs. 53.3%, p = .010) and post-operative (75.5% vs. 45.0%, p < .001) transfusions more frequently than the NEG group, despite similar amounts of blood loss. SFMC tests in CPB may be associated with patient pre-operative status and an increase in transfusion requirements.
authors.affiliation: University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Bonk
authors.forename: Cody
authors.initials: C
authors.lastname: Trowbridge
authors.forename: Alfred
authors.initials: A
authors.lastname: Stammers
authors.forename: Myra
authors.initials: M
authors.lastname: Klayman
authors.forename: Molly
authors.initials: M
authors.lastname: Marko
authors.forename: Nicholas
authors.initials: N
authors.lastname: Brindisi
authors.forename: James
authors.initials: J
authors.lastname: Pezzuto
mesh_terms: D000368:Aged; D016913:Blood Component Transfusion; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C011468:fibrinmonomer