RETRACTED: Does the preparation of heparin influence anticoagulation during cardiopulmonary bypass?
Various preparations of heparin from different manufacturers are commercially available. The influence of bovine lung heparin (BLH) and porcine mucosal heparin (PMH) on anticoagulation and heparin plasma concentration was investigated in four groups of 10 patients undergoing elective aortocoronary bypass grafting either after single dose or repetitive dose (after 60 minutes) of one of these heparin preparations. Heparin plasma concentration increased significantly after injection of heparin (BLH: minimum, 1.67 U/mL; maximum, 2.10 U/mL; PMH: minimum, 1.69 U/mL; maximum, 2.15 U/mL). Sixty minutes after the initial dose, heparin plasma levels were higher in the patients who received PMH. Supplemental heparin doses 60 minutes after the loading dose increased plasma heparin concentration only with porcine mucosal heparin. Elimination of heparin in the urine was not different among the groups. Fibrinogen and antithrombin III concentrations, as well as activated clotting time (ACT; always greater than 400 seconds) and partial thromboplastin time (PTT; always greater than 300 seconds), did not differ among the groups, indicating effective anticoagulation during the bypass period with both types of heparin. It can be concluded that sufficient anticoagulation can be achieved with either kind of heparin. PMH seems to be longer acting and a repeat dose in these patients seems to be necessary only if cardiopulmonary bypass lasts longer than 90 minutes.
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
J
J
Boldt
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
B
B
Zickmann
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
M
M
Ballesteros
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
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D
Scholz
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
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F
Dapper
From the Departments of Anesthesiology and Intensive Care Medicine and Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
G
G
Hempelmann
D000368:Aged; D000818:Animals; D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation / Q000187:drug effects*; D002315:Cardiopulmonary Bypass; D002417:Cattle; D005340:Fibrinogen / Q000032:analysis; D006493:Heparin / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D008168:Lung; D008875:Middle Aged; D009092:Mucous Membrane; D010314:Partial Thromboplastin Time; D013552:Swine
D000990:Antithrombin III; D005340:Fibrinogen; D006493:Heparin