Heparin-coated versus uncoated extracorporeal circuit in patients undergoing coronary artery bypass graft surgery.
OBJECTIVE
To assess the effect of heparin-coated circuits on bleeding, transfusion, and platelet count in patients undergoing primary coronary artery bypass grafting with full heparinization.


METHODS
Randomized, double-blind study.


METHODS
Tertiary-care academic medical center.


METHODS
Eighty-eight patients undergoing coronary artery bypass grafting requiring cardiopulmonary bypass (CPB) without previous sternotomy.


METHODS
Subjects received either a heparin-coated or an uncoated extracorporeal circuit for CPB. Heparin, 300 micro/kg, was administered, and supplemental amounts were administered to maintain an activated coagulation time of greater than 480 seconds. Platelet counts were determined during CPB. Mediastinal chest tube drainage was collected in the intensive care unit for 24 hours.


RESULTS
The mean platelet counts were similar between the groups during CPB. There was no significant difference in 24-hour mediastinal chest tube drainage (mean +/- standard deviation; median) between the heparin-coated (n = 44, 1096 +/- 401, 1015 mL) and uncoated group (n = 44, 1150 +/- 548, 1040 mL; p = 0.91). The heparin-coated group received less allogeneic packed red blood cells (0.9 +/- 1.6, 0.0 v 1.5 +/- 1.8, 1.0 U; p = 0.04).


CONCLUSIONS
The use of a heparin-coated or uncoated cardiopulmonary bypass circuit and full heparinization marginally reduced only red blood cell transfusion but was not associated with platelet sparing or reduced perioperative bleeding.
Oliver
William C
WC
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA. oliver.william@mayo.edu
Nuttall
Gregory A
GA
Ereth
Mark H
MH
Santrach
P J
PJ
Buda
Daniel A
DA
Schaff
Hartzell V
HV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D004311:Double-Blind Method; D005112:Extracorporeal Circulation; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count
D000925:Anticoagulants; D006493:Heparin