Extracorporeal circulation (ECC) leads to thrombin formation, coagulation factor consumption, platelet depletion and fibrinolysis activation. Several mechanisms are involved: haemodilution, contact with foreign surfaces and air, traumatic pump and suction injuries, hypothermia, systemic inflammatory syndrome. These phenomena require careful management to avoid thrombosis during and haemorrhage after ECC. The current trend is towards protocol-based intraoperative coagulation management based on laboratory tests performed in operating room (goal-directed blood management). Strategy is threefold:
- Treating coagulopathy ;
- Preventing thrombosis ;
- Reduce bleeding and transfusions.
Which is detailed later in this chapter (see Intraoperative haemotherapy).
© CHASSOT PG, MARCUCCI Carlo, last update November 2019.