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Clinical Use of Heparin-Coated Cardiopulmonary Bypass in Coronary Artery Bypass Grafting*
- Source :
- The Thoracic and Cardiovascular Surgeon. 49:131-136
- Publication Year :
- 2001
- Publisher :
- Georg Thieme Verlag KG, 2001.
-
Abstract
- Clinical handling, risk and benefit of a heparin-coated cardiopulmonary bypass system combined with reduced systemic heparinization in coronary bypass surgery was investigated in a prospective, randomized clinical study. 243 patients (Pts.) were divided into 3 groups: group A (n = 83) had a standard uncoated extracorporeal circulation (ECC) set, and systemic heparin was administered in an initial dose of 400 IE/kg body weight. During ECC activated clotting time (ACT) was kept > or = 480 sec. Group B (n = 77) had the same ECC set completely coated with low-molecular-weight heparin; i.v. heparin was given in the same dose as in group A, ACT was kept at the same level. Group C (n = 83) had the same coated ECC set as group B, but i.v. heparin was reduced to 150 IE/kg, and was set to be > or = 240 sec during ECC ACT. The same circulatory components were used in all 3 groups including roller pumps, coronary suction and an open cardiotomy reservoir. In the postoperative clinical course, recovery was not significantly different between groups, especially with respect to organ dysfunction; but there was significantly reduced postoperative bleeding where heparin-coated ECC and low-dose systemic heparinization were both used. This circulatory technique was also associated with a distinctly lower need for postoperative blood replacement. We conclude that heparin-coated extracorporeal circulation combined with either full-dose or reduced systemic heparinization can be used effectively with the same standard equipment and procedures as in uncoated technology. Combination with low-dose i.v. heparin leads to significantly decreased blood loss and less need for blood replacement.
- Subjects :
- Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.drug_class
Myocardial Infarction
Activated clotting time
Low molecular weight heparin
Coronary Disease
Hemorrhage
law.invention
Postoperative Complications
law
Internal medicine
Cardiopulmonary bypass
Humans
Medicine
Prospective Studies
Protamines
Renal Insufficiency
Myocardial infarction
Coronary Artery Bypass
Aged
Cardiopulmonary Bypass
Dose-Response Relationship, Drug
medicine.diagnostic_test
business.industry
Extracorporeal circulation
Anticoagulants
Heparin
Heparin, Low-Molecular-Weight
Length of Stay
Middle Aged
medicine.disease
Paresis
Stroke
medicine.anatomical_structure
Bypass surgery
Cardiology
Surgery
Cardiology and Cardiovascular Medicine
business
medicine.drug
Artery
Subjects
Details
- ISSN :
- 14391902 and 01716425
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- The Thoracic and Cardiovascular Surgeon
- Accession number :
- edsair.doi.dedup.....1ad190f36d371c0c7f6ad4e37419e645