Abstract
#Cardiopulmonary bypass (CPB) is associated with common
activation of all four integral components of hemostasis, that is,
the endothelium, plasma proteins, platelets and #fibrinolysis. The
causative factors include the presence of an artificial non-endothelial
surface of the CPB system, non-pulsatile blood flow, #hemodilution,
hypothermia, #surgical trauma and a systemic inflammatory
response to CPB. Microthrombi formation, coagulation defects
and hypercoagulability in the postoperative period may occur. The
key pathway of activation is platelet binding to collagen via von
Willebrand factor, platelet activation and aggregation and formation
of an initial hemostatic plug. Thrombin generation (tF+fVIIa →fIXa
→fXa →prothrombin →thrombin) activates platelets, fV, fVIII and
fXI. Fibrinogen and fXIII stabilize the clot.
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