Experimental evaluation of heparin-coated cardiopulmonary bypass equipment with low systemic heparinization and high-dose aprotinin.
Cardiopulmonary bypass (n = 8 calves) with heparin-coated perfusion equipment, low-dose systemic heparinization (activated clotting time: ACT greater than 180 s) and high-dose aprotinin administration was evaluated in comparison to standard perfusion equipment with full-dose systemic heparinization (ACT greater than 480). All animals were perfused for 6 hours and similar values were observed for blood gases and mixed venous oxygen saturation in both groups. The heparin doses given in the study group before and during the 6 hours of perfusion totalized 14660 +/- 2553 IU as compared to 60833 +/- 5137 IU for the control group. No protamin was given in the study group whereas an equivalent of 27000 +/- 5805 IU was necessary to reverse heparin in the control group. There was no difference for prebypass hematocrit versus postbypass hematocrit in the two groups. Prebypass plasma hemoglobine was 8.4 +/- 2.1 mumol/L in the study group versus 10.0 +/- 3.8 mumol/L in the control group. After mixing with the priming volume, plasma hemoglobine was 8.6 +/- 2.5 mumol/L in the study group versus 6.7 +/- 1.6 mumol/L in the control group. The highest value was observed in the study group after 2 hours of perfusion (8.2 +/- 2.1 mumol/L) versus 5 hours of perfusion in the control group (7.4 +/- 3.6 mumol/L). Prebypass LDH levels of 1610 +/- 150 IU in the study group versus 1740 +/- 210 IU in the control group moved to 1870 +/- 200 IU in the study group at 24 hours after perfusion versus 2650 +/- 400 IU in the control group at 24 hours and decreased thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)
von Segesser
L K
LK
Clinic for Cardiovascular Surgery, Institute of Anesthesiology, University Hospital, Zürich, Switzerland.
Weiss
B M
BM
Pasic
M
M
Leskosek
B
B
von Felten
A
A
Pei
P
P
Turina
M
M
D000818:Animals; D007611:Aprotinin / Q000008:administration & dosage / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D002417:Cattle; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects*; D006493:Heparin / Q000008:administration & dosage / Q000494:pharmacology*; D006863:Hydrogen-Ion Concentration; D007770:L-Lactate Dehydrogenase / Q000097:blood / Q000187:drug effects*; D010100:Oxygen / Q000097:blood; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D011184:Postoperative Period; D011300:Preoperative Care
D006454:Hemoglobins; D006493:Heparin; D007611:Aprotinin; D007770:L-Lactate Dehydrogenase; D010100:Oxygen