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Abstract Bleeding is one of the major complications after cardiopulmonary bypass (CPB). In the earlier days of cardiopulmonary bypass, the cellular and molecular elements of blood sustained significant mechanical trauma during perfusion, resulting in destruction of red cells, platelets and denaturation of plasma proteins. Post CPB platelet dysfunction, dilutional coagulopathy and abnormal fibrinolysis contribute to this bleeding tendency and increase the need for homologus blood products transfusion. The beneficial effect of each unit of blood or blood component transfused is accompanied by the possibility that the patient may experience an adverse reaction to the transfusion. Because of the multifactorial etiology of the CPB-induced hemostatic defect, a multimodal approach to blood conservation and hemostasis must be employed throughout the entire perioperative period. |