[The pathogenesis factors of intraoperative hemolysis in cardiac surgery]

Abstract

As shown in various studies, hemolysis is revealed in all extracorporeal circuits showing the increasing levels of plasma-free hemoglobin (PfHb) during and after cardiopulmonary bypass (CPB). The pathogenesis factors and mechanisms of intraoperative hemolysis are observed in this article. The role of mechanical blood trauma, oxygen free radical generation, activation of complement, preoperative defects erythrocytes, infusion preparations and other medicaments in postperfusion hemolysis are discussed. Along with the complete red blood cell (RBC) destruction (hemolysis), RBCs can also be damaged on a sublethal level, resulting in altered rheological properties, decreased microcirculation and organ dysfunction caused by hypoxia. The severity of the consequences of RBC damage, the high incidence of this complication and the lack of interventional strategies in cases of suspected or confirmed RBC damage are considered, there may be a need for a treatment algorithm for this phenomenon.