Cardiopulmonary bypass in humans: bypassing unfractionated heparin.
Seven anticoagulants besides unfractionated heparin have been used for human cardiopulmonary bypass (CPB), mainly in patients with heparin-induced thrombocytopenia. The collective experience with these alternative anticoagulants provides a perspective on current efforts aimed at improving CPB anticoagulation. Unfortunately, each alternative currently lacks a standard dosing schedule and a reliable method of monitoring the adequacy of its anticoagulant effect during CPB. Most also lack proven antidotes. Thus, unfractionated heparin remains the anticoagulant of choice for standard CPB.
Frederiksen
J W
JW
Department of Surgery, Northwestern University Medical School, Chicago, Illinois 60611, USA. jwf@nwu.edu
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D013921:Thrombocytopenia / Q000139:chemically induced / Q000517:prevention & control
D000925:Anticoagulants; D006493:Heparin