Overview

Cardiopulmonary bypass surgery degrades hemostasis. There are multiple contributing factors to this degradation. Heparin is added to inhibit coagulation; blood volume is diluted; coagulation factors and platelets are activated by bypass circuits and surgical trauma; heparin is reversed with protamine restoring coagulation; and bleeding depletes clotting factors and platelets.

During bypass, inadequate anticoagulation elevates thrombotic risks. Excessive anticoagulation potentially impairs hemostasis restoration. Accurate anticoagulation management reduces both thrombotic risk during bypass and potential bleeding complications after bypass. Post bypass, hemostasis may be impaired by loss of clotting factors or platelets, residual heparin, or excessive uncorrected vascular damage. Blood component therapy may be necessary to control bleeding, but unnecessary use of blood products should be avoided.Hemostasis performance and clinical management affect patient outcomes and treatment costs. Effective and comprehensive hemostasis management is one important component of cardiopulmonary bypass surgery.

Hemostasis Management Testing Needs

Cardiopulmonary bypass surgery teams need to manage heparin administration, neutralize heparin, and resolve bleeding complications. The specific requirements for hemostasis management throughout cardiopulmonary bypass surgery may include: pre-surgical screening for potential existing coagulopathies, verification of adequate anticoagulant therapy prior to bypass, management of anticoagulant therapy during bypass, and comprehensive hemostasis assessment post bypass and throughout recovery.Technology trends are moving more advanced instruments into the operating room offering comprehensive test results of coagulation assessment, platelet function, and overall hemostasis performance with pointof-care convenience. 

Hemostasis Management and the Sonoclot Analyzer

The Sonoclot Analyzer is a sensitive instrument designed to detect and quantify viscoelastic changes in a whole blood sample that occur throughout hemostasis. Hemostasis testing with the Sonoclot Analyzer has evolved to address multiple needs of cardiopulmonary bypass surgery including both anticoagulation and bleeding management. The Sonoclot Analyzer product line is the only integrated solution that addresses both convenient and cost effective anticoagulation management with global hemostasis monitoring for managing clinical bleeding.