Hypercoagulant Abdominal Swabs in Cardiac Surgery: Potential Problems and Background

The Thoracic and Cardiovascular Surgeon
Stefanie KrajewskiHans P Wendel

Abstract

Background During cardiac surgery with heart-lung-machine support, abdominal swabs are routinely used to adsorb blood from the operation field. In part, abdominal swabs exhibit procoagulant activity, which is usually considered harmless. However, coagulation induction and abnormal clot formation on the surface of abdominal swabs in the operation field may, if the blood is retransfused into the extracorporeal circuit, lead to severe thromboembolic complications. The aim of the present study was to elucidate the origin of the unexpected blood clotting upon contact with hypercoagulant swabs. Methods The coagulant properties of three abdominal swabs were characterized using a simple clotting test and human whole blood, which was anticoagulated with different heparin concentrations. Eluates prepared from the abdominal swabs and the color stabilizer polydiallyamine (PDAA) were incubated with blood and blood clotting was investigated. Furthermore, the effects of the abdominal swabs on blood clotting time and on heparin were investigated. Results Our data show that the three abdominal swabs as well as the respective eluates exhibit distinctive coagulant properties. The abdominal swab with the highest hypercoagulant effect significantly...Continue Reading

Citations

Nov 24, 2018·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Stefan TrunkSandra Stoppelkamp
Feb 23, 2019·Journal of Biomaterials Applications·Cornelia WiegandSandra Stoppelkamp

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