Decreased blood loss after cardiopulmonary bypass using heparin-coated circuit and 50% reduction of heparin dose.
In a randomized, double-blind study of patients undergoing elective coronary artery grafting, the effect of heparin-coated circuit combined with 50% reduction of systemic heparin bolus was investigated. Ten patients comprised group HC (heparin-coated) and ten group C (controls). The mean total doses of heparin were 172 IU/kg in group HC and 416 IU/kg in group C and the respective protamine doses were 0.96 and 3.96 mg/kg (both p < 0.001). Activated clotting times during cardiopulmonary bypass were significantly shorter in group HC, and both intra- and postoperative bleeding was significantly less than in group C (7.7 vs. 11.7 ml/kg, p = 0.036, and 6.9 vs. 9.7 ml/kg, p = 0.004). Hemoglobin loss via the drains was 22.5 g in group HC and 43.7 g in group C (p < 0.005). Hemolysis at the end of bypass was significantly greater in group C. Apart from one perioperative myocardial infarction in group HC the postoperative course was uneventful. Use of a heparin-coated circuit is concluded to permit complication-free reduction of heparin and protamine doses and to decrease both intra- and postoperative bleeding, which may favorably influence the outcome of coronary artery grafting.
Borowiec
J
J
Department of Thoracic Surgery, University Hospital, Uppsala, Sweden.
Thelin
S
S
Bagge
L
L
Hultman
J
J
Hansson
H E
HE
D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001810:Blood Volume; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis / Q000187:drug effects; D006493:Heparin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009200:Myocardial Contraction / Q000187:drug effects; D010976:Platelet Count; D013499:Surface Properties; D014556:Urine
D005338:Fibrin Fibrinogen Degradation Products; D006454:Hemoglobins; D006493:Heparin