Introduction: If before establishment of CPB, anticoagulation state not to be formed because of intrinsic all CPB trombogeny of circulatory system outside the somatosensory. Biomaterial endothelial level is responsible for starting coagulation.Goal: To determine the reasons of anticoagulation during CPBMethods: Study and research on internet and review of literature.Problem Statement: The healthy vascular endothelium consists anticoagulation properties (both passive and active). These properties involve: 1- To release prostacyclin and relaxant factor of vascular, derived from endothelium which present aggregation of platelet and cause the movement of blood. 2- Activation of physiological anticoagulant called protein cands. 3- Non-activation is thrombin. The level of the circulatory system outside the somatosensory directly activates platelet, serine- proteases and the other increase active coagulation products of blood in blood circulation and in blood returned by suction from surgery environment during CPB. But in general the probability of small coagulation increases, consequently the risk of cerebral embolism increase.Conclusion: To prevent coagulation during CPB should use anticoagulation medicine. In order to create anticoagulation state and it must be preserved during CPB anticoagulation state usually are obtained and maintained with heparin.

Introduction: In the first years of open cardiac surgery, it was common for transfusion of a few unit allogenic bloods. In 1990,s most adults have open cardiac surgery for the first time, they receive no blood allogenic. This change in use of products of blood is the result of numerous changes in management of patient in before, during and after surgery, concluding preserving autologous blood acceptance of low hemoglobin levels, improvement in surgical products and applying compatible biomaterial. In blood circulatory system outside the somatosensory.Goal: To determine the causes of bleeding and finding resolution to prevent bleeding after cardiopulmonary Bypass.Method: Study and research on internet and review of literature.Problem Statement: Despite these developments, CPB causes bleeding in some patient, so, they require transfusion of multiple blood products around the time of surgery. These patients are re-evaluated because of abnormal bleeding. Some specific locations of bleeding in these patients will be found. Although in other patients bleeding is referred to defects of acquired homeostatic. The hemorrhagic complications may be such as reoperation impaired work in both ventricles and the effects of accumulation of blood in the pericardial and delayed closure of sternum. Many mechanisms interfere in homeostatic disorders during CPB, involved exposing blood to biomaterial level of blood circulator system out side the somatosensory dilated blood hypothermia, endocrine response to stress, extensive surgery, drug consumption during operation, use of heparin, disorder of coagulation factors and heparin. Main reason of bleeding after cardiac surgery using CPB is activation of fibrinolisis with time of CPB.Conclusion: The relative effect of these factors on homeostasis defects, caused by CPB is not clear, so it is necessary to have a multiple method for cardiac surgery, anesthesia, and perfusion technology and hematology and transfusion medicine. In order to make easy detection of bleeding in patient at risk of bleeding and to create appropriate treatment while bleeding.

Introduction: Coronary artery Bypass graft is one of the most common surgeries in hospitals. Almost 50% of patients have complications. One of these complications is hearing loss.Materials and Methods: Coronary artery Bypasses grafting patients having inclusion criteria participated. One day before surgery, One day after surgery and if patients had hearing loss, the next week otoacoustic emission test was done. Patients were divided in to two groups: on pump and off pump Bypass surgeries.Results: Hearing loss occurred in 12%. Hearing loss in on-pump patients was 14.3% and in off-pump was 6/7% (p=0.09). The relation of preoperative OAE test and final OAE was tested and it was significant (p<0.005). In male patients, hearing loss in on-pump operation was 18/6% (p=0.002) and in females in on-pump operation was 7/4% and in off-pump operation was 18.2 %( p=0.1). Hearing loss occurred in 4/2% in 1500, 2000 HZ; 12/5% in 2500, 3000 HZ and 83/3% in 3500, 4000 HZ.Conclusion: It after coronary artery Bypass graft is rather Frequents (12%) and is more common in on-pump surgery, and occurs in high frequency. hearing loss is more common in male patients.

Introduction: The most severe form of hemodynamic instability is vasoplegic syndrome. Case Presentation: This case report presents a case of vasoplegic syndrome in a patient with a twin pregnancy during cardiopulmonary Bypass. Conclusions: In this case, we managed vasoplegia by maintaining high flows of the cardiopulmonary Bypass, reducing the use of volatile anesthetics, administering vasoactive drugs, and optimizing hemoglobin levels above normal thresholds.

Background: It is estimated that cardiopulmonary disorders eslkjpecially coronary artery disease are the leading causes of mortality in world and Iran. The arteriosclerotic process in the coronary arteries, as in other blood vessels, consists of focal intimal accumulation of lipids, complex carbohydrates, blood and blood products, fibrous tissue, and calcium deposits associated with changes in the media, that causes unstable angina and myocardial infarction. Treatment of these patients is medical therapy and coronary artery Bypass grafts surgery (CABGs) with or without cardiopulmonary Bypass (CPB). The aim of this research is studying One Years Clinical Outcome after Coronary Artery Bypass.Methods: This research is cross sectional and case control trial study. It was performed in Shahid Madani hospital in Tabriz – iran during the year 2006-2007. The patients who had CABGs with or without CPB were studied. The information was collected by filling a questionnaire and was analyzed by the t-test and chi-square program. Results: In this study 196 patients had CABG without CPB (group I) and 133 with CPB (group II). Number of grafts in group I 2.49±0.04 and 2.73±0.04 in group II. The rate of complications in 2 groups was not significant, EF is improved in group I, and use of Inotrops and IABP was less than in group II. In group I hospitalization (ICU, hospital) was less than in comparison with group II.Conclusion: According to results CABG without CPB is a safe method. According to results out comes of this study is comparable with other studies in world.