Bleeding diathesis |
- Decreased platelet count
- Splanchnic sequestration of platelets
- Partial activation of circulating platelets causing aggregation and adhesion
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- Slowing of enzymatic reactions in the coagulation cascade
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- Enhanced fibrinolysis as a consequence of vascular injury
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- Impairment of tissue factor activity
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- Inflammatory responses to CPB
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- Ischemia-reperfusion injury that further exacerbates coagulopathy
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- Disseminated intravascular coagulation may occur
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Cardiovascular effects |
- Prolongation of PR interval and QRS complex on the ECG
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- Vasoconstriction during cooling and hypothermia
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- Vasodilation during rewarming and reperfusion
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Hyperglycemia due to: |
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- Glucocorticoid administration
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- Catecholamine administration
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Changes in metabolic rate |
- Decreased metabolic rate and oxygen consumption during hypothermia
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- Increased metabolic rate during rewarming, particularly with shivering (mitigated by administration of neuromuscular blocking agents)
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Decreased metabolism of drugs |
Decreased anesthetic requirements |
Leftward shift of the oxygen-hemoglobin dissociation curve, with increased binding affinity of hemoglobin to oxygen |