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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 108-116, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
CR Valeri, K Khabbaz, SF Khuri, C Marquardt, G Ragno, H Feingold, AD Gray and T Axford
Thirty-seven patients undergoing cardiopulmonary bypass operations were
studied to assess the effect of skin temperature on platelet function.
Differences in skin temperature between the two arms were created during
bypass, at the completion of bypass, and at 2 and 24 hours after the
completion of bypass. In each of 37 patients the temperature of one arm was
increased with a water-filled blanket set at 40 degrees C. In 11 of these
patients the other arm was allowed to equilibrate with the environment, and
in the other 26 patients the arm was cooled with ice. Except for the
differences in local skin temperature between the two arms, all factors
known to affect the patient's bleeding time were similar. Measurements were
made of bleeding times and the levels of thromboxane B2 and
6-keto-prostaglandin F1 alpha in shed blood obtained at the template
bleeding time site. In the 33 patients not treated with aspirin, local
hypothermia produced an increased bleeding time and a significant reduction
in the thromboxane B2 level at the bleeding time site, but no reduction in
6-keto-prostaglandin F1 alpha level. Local rewarming produced a significant
increase in the shed blood thromboxane B2 level. In the four patients
treated with aspirin, local hypothermia produced no differences in bleeding
times or shed blood levels of thromboxane B2 or 6-keto-prostaglandin F1
alpha. These data show the benefits of rewarming patients with hypothermia
who have nonsurgical blood loss to restore to normal both core and
peripheral temperatures before resorting to the transfusion of homologous
blood products.
ARTICLES
Effect of skin temperature on platelet function in patients undergoing extracorporeal bypass
Naval Blood Research Laboratory, Boston University School of Medicine, MA 02118.
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