title: Monitoring of blood coagulation in open heart surgery. II. Use of individualized dosages of heparin and protamine controlled by activated coagulation times.
abstract: Results are presented of individualized anticoagulatory management during open heart surgery in two groups of 20 patients comparing colloid versus non-colloid priming of the extracorporeal circuit. Advantages of individualized dosages of heparin according to a constructed dose response curve and controlled by measuring Activated Coagulation Times (ACT) were safer adaptation to individual variability in heparin sensitivity, reduction of incremental heparin doses during cardiopulmonary by-pass and nearly 50% reduction of protamine dosage as compared to conventional heparinprotamin protocols. No significant influence of the type of priming used in the extracorporeal circuit on coagulatory behaviour could be detected.
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011479:Protamines / Q000008:administration & dosage*; D014914:Whole Blood Coagulation Time
chemical_list: D011479:Protamines; D006493:Heparin