A global assay of haemostasis which uses recombinant tissue factor and tissue-type plasminogen activator to measure the rate of fibrin formation and fibrin degradation in plasma.

The global assay of Overall Haemostasis Potential we previously described has been refined. The coagulation cascade in platelet-poor plasma is triggered by adding a minimal dose of recombinant tissue factor together with purified phospholipids and calcium; fibrinolysis is initiated by adding recombinant tissue type-plasminogen activator in a concentration similar to what can be obtained during thrombolysis. Numerical differentials of optical densities reflecting rates of fibrin formation and degradation are calculated by a new software, and the Coagulation Profile (Cp) and the Fibrinolysis Profile (Fp) are determined.

Pulmonary hemodynamics and gas exchange in off pump coronary artery bypass grafting.

Objectives: To investigate the influence of cardiopulmonary bypass on pulmonary hemodynamics and gas exchange.

Methods: Low risk patients admitted for elective coronary artery bypass grafting were randomized to either on (n=25) or off pump (n=25) surgery. Central hemodynamics, gas exchange, and venous admixture were studied during and up to 20 h after surgery.

Cardiovascular function during the first 24 hours after off pump coronary artery bypass grafting--a prospective, randomized study.

We hypothesized that cardiovascular performance during the first 24 postoperative hours would be better in patients after off pump coronary artery bypass grafting compared to conventional on pump surgery. Fifty-nine patients were randomized to on or off pump coronary artery bypass grafting. Hemodynamic parameters, including cardiac index and systemic vascular resistance index were measured before and at 1, 4, and 20 h after surgery.

Preoperative unstable angina causes venous adaptation to surgical graft injury.

Ischemic preconditioning may provide a systemic organ protection, evident as the phenomenon known as remote preconditioning. Unstable angina may be a clinical analogue to ischemic preconditioning. Vein graft harvesting induces inflammation of the graft wall.

Comparison of three different chest drainages after coronary artery bypass surgery--a randomised trial in 150 patients.

Objective: Drainage of blood from the mediastinum and pleura following open cardiac procedures is usually carried out using one or more large-bore plastic chest tubes. Recently small diameter siliastic drains have been reported to evacuate blood with a better patient comfort. The efficacy and safety of different chest tubes have not yet been fully evaluated.

Vein graft harvesting induces inflammation and impairs vessel reactivity.

Background: Saphenous veins are often used for coronary artery bypass grafting (CABG), but loss of patency is a problem. The surgical procedure may contribute to graft injury. Our aim was to study the impact of surgical handling of saphenous veins on graft inflammation and vascular function.

Cognitive function after on or off pump coronary artery bypass grafting.

Objective: To investigate cognitive outcome after on and off pump coronary artery bypass grafting.

Methods: Seventy patients between 50 and 80 years with stable angina pectoris, ejection fraction >30%, serum creatinine <150 micromol/l, and lack of tight main stem stenosis were randomized to on or off pump coronary artery bypass grafting. Standardized neuropsychological tests evaluated attention, verbal and visuo-spatial short-term and working memory, verbal learning, delayed recall, visuo-motor speed, and aspects of executive functions.

Peripheral blood monocyte activation during coronary artery bypass grafting with or without cardiopulmonary bypass.

Objective: The aim of this prospective, randomized study was to investigate the impact of coronary artery bypass grafting (CABG) on peripheral monocytes and to evaluate the additional effect of cardiopulmonary bypass (CPB).

Design: Twenty patients admitted for elective CABG were randomized to either on-pump (ONCAB, n = 9) or off-pump (OFFCAB, n = 11) surgery and blood samples were drawn before, during and 24 h after the operation. The total number of monocytes and the proportion of the more mature CD16+/CD14+ monocytes were measured.

Hemostasis in off-pump compared to on-pump coronary artery bypass grafting: a prospective, randomized study.

Background: We hypothesized that off-pump coronary artery bypass grafting has less impact on the hemostatic systems than on-pump surgery.

Methods: Thirty-one patients were randomized to on-pump or off-pump coronary artery bypass grafting. Factors of hemostasis as well as markers of endothelial activation were measured up to 24 hours after the operation: Fibrin D dimer, prothrombin fragment 1+2, alpha2-macroglobulin, protein C1 esterase inhibitor, fibronectin, and von Willebrand factor.

Activation of complement and leukocyte receptors during on- and off pump coronary artery bypass surgery.

Objective: The aim of this prospective, randomised study was to investigate the influence of extracorporeal circulation on the inflammatory response, our hypothesis being that off pump coronary artery bypass grafting (OFFCAB) procedures would generate less activation than on pump procedures (ONCAB).

Methods: Patients admitted for elective CABG were randomised to either ONCAB or OFFCAB surgery and blood samples were taken during and up to 24 h after the operation. We measured complement factors C5a and the terminal complement complex (TCC, C59-b), and the interleukins IL-6 and IL-8.