title: Coagulation patterns in bovine left heart bypass with phospholipid versus heparin surface coating.
abstract: The current study was designed to evaluate tubing sets with either polymeric phospholipids or ionically bound heparin in six bovine experiments (body weight, 70 +/- 5 kg). No heparin was given systemically. Left heart bypass was started with 300 ml of clear priming solution and maintained over 6 hours (50 ml/kg/min). Coagulation studies included platelet counts, activated coagulation time (ACT), thrombin time (TT), fibrinogen (Factor I), antithrombin III (AT III), and fibrinopeptide A (FPA). Normalized platelet levels dropped from 100 +/- 12% before to 86 +/- 13% after 6 hours of left heart bypass for heparin, compared with 100 +/- 46% to 90 +/- 44% for phospholipid coating (NS). The ACT increased from 146 +/- 7 sec at 10 min to 159 +/- 16 sec after 6 hours for heparin, compared with 122 +/- 4 to 126 +/- 5 sec for phospholipid (p < 0.05). Thrombin time changed from 18 +/- 0 sec before to 19 +/- 1 sec after 6 hours for heparin, as compared with 16 +/- 1 sec to 18 +/- 1 sec for phospholipid (NS). Factor I levels decreased from 1.5 +/- 0.3 g/L to 1.3 +/- 0.1 g/L for heparin, compared with 1.5 +/- 0.2 g/L to 1.4 +/- 0.3 g/L for phospholipid. Antithrombin III levels changed from 102 +/- 26% to 91 +/- 7% for heparin, compared with 123 +/- 12% to 118 +/- 12% for phospholipid. Fibrinopeptide A levels changed from 100 +/- 60% to 130 +/- 13% for heparin, compared with 100 +/- 11% to 99 +/- 6% for phospholipid (P < 0.05). No macroscopic red clots were found in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital, Zürich, Switzerland.
authors.forename: L K
authors.initials: LK
authors.lastname: von Segesser
authors.forename: A
authors.initials: A
authors.lastname: Olah
authors.forename: B
authors.initials: B
authors.lastname: Leskosek
authors.forename: M
authors.initials: M
authors.lastname: Turina
mesh_terms: D000818:Animals; D000990:Antithrombin III / Q000032:analysis*; D002417:Cattle; D005340:Fibrinogen / Q000032:analysis*; D006353:Heart-Assist Devices; D006493:Heparin / Q000737:chemistry*; D010743:Phospholipids / Q000737:chemistry*; D010976:Platelet Count; D011108:Polymers; D013918:Thrombin Time; D014914:Whole Blood Coagulation Time
chemical_list: D010743:Phospholipids; D011108:Polymers; D000990:Antithrombin III; D005340:Fibrinogen; D006493:Heparin