Hematologic Changes Observed After Extracorporeal Circulation During Open-Heart Operations*

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HEMATOLOGIC studies were performed to detect whether or not alterations occurred in the formed elements of the blood in 12 consecutive patients who underwent open-heart operations with the use of heart-lung machines. The rotating disk types of oxygenator were used, the Björk, the Kay and Cross, and the Melrose. Eight of the patients were children less than 14 years of age, and four were adults. The duration of the extracorporeal circulation ranged from 9 to 24 minutes and averaged 18 minutes.

Methods and Technic

The following hematologic determinations were made prior to operation and usually repeated on the first, third, and seventh postoperative days: hemoglobin content of the blood, erythrocyte and leukocyte counts, differential leukocyte count, hematocrit value, icterus index, reticulocyte percentage, platelet count (Rees-Ecker method), bleeding time (Ivy method), coagulation time (Lee-White method), clot retraction, and one-stage prothrombin time. Additional determinations, such as plasma hemoglobin, fibrinogen, fibrinolytic activity, serum bilirubin value, Coombs reaction, and protamine titration, were made when indicated. For several patients, hematologic determinations were made periodically for six months after operation.

Analysis of Results

A review of the data indicates that no serious hematologic changes occurred in the 12 patients whose circulation was maintained by the oxygenator during open-heart operations.

The clinical examinations and the laboratory studies disclosed no hematologic disorders prior to operation. Three patients had a moderate, and one patient, a severe, hypoxemic erythrocytosis (hematocrit value of 72 ml. per 100 ml. of blood) which disappeared after surgical correction of the congenital cardiac defect. During. . .



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