Hematological Changes in Patients Undergoing Coronary Artery Bypass Surgery: a Prospective Study.
OBJECTIVE
Removal of pro inflammatory stimuli after CABG, wound closure and the regenerative ability of the bone marrow will ensure a gradual recovery of hematological parameters. The aim of this study was to assess the hematological changes after CABG.


METHODS
A prospective cohort study included 164 consecutive patients undergoing on pump CABG surgery between January 2012 and January 2013. Patients with primary hematologic disease, emergent or urgent CABG and off-pump CABG were not included. A time line protocol was employed.


RESULTS
All patients survived surgery. Average values of erythrocytes, hemoglobin and hematocrit declined, to reach lower values on day 3 after surgery (-33.6 %, -33.1 %, -32.6 % versus preoperative value, p<0.001) and then gradually increased to reach normal values after one month and the preoperative values after three months. The average values of leukocytes and neutrophils increased rapidly to achieve the highest value on day 2, while the average value of lymphocytes decreased quickly to achieve lower value on day 1 after surgery (+74.7 %, +127.1 %, -52.4 % respectively from the preoperative value, p<0.001). The average platelet count decreased to the lowest value on day 2 after surgery (-26.4 % from the preoperative value, p<0.001), after which gradually increased up to +100.8 % of preoperative value on day 14 (p<0.001) and then gradually decreased to reach normal values on day 21 and preoperative values after three months.


CONCLUSIONS
Average values of the three peripheral blood cells parameters undergo important changes after CABG, but not life threatening, and regain normal and preoperative values after 1-3 months after surgery.
Department of Internal Medicine, American Hospital, Tirana, Albania.
Sotir
S
Lako
Division of Hematology and Laboratory Medicine, University Hospital Center of Tirana, Albania.
Teuta
T
Dedej
Division of Hematology and Laboratory Medicine, University Hospital Center of Tirana, Albania.
Tatjana
T
Nurka
Division of Hematology and Laboratory Medicine, University Hospital Center of Tirana, Albania.
Vera
V
Ostreni
Division of Cardiac Surgery, University Hospital Center of Tirana, Albania.
Aurel
A
Demiraj
Division of Cardiac Surgery, University Hospital Center of Tirana, Albania.
Roland
R
Xhaxho
Division of Cardiac Surgery, University Hospital Center of Tirana, Albania.
Edvin
E
Prifti
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004906:Erythrocyte Count; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors
D006454:Hemoglobins
Cardiac surgery; Coronary artery bypass grafting; Peripheral blood; Regenerative