title: A comparison of low vs conventional-dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery.
abstract: The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high-dose anticoagulation with a low-dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred patients who received 300 IU.kg(-1) heparin were compared with 68 patients who received heparin according to an individually adjusted activated coagulation time target of 300 s, resulting in a mean (SD) heparin dose of 145 (30) IU.kg(-1) . There were no thromboembolic events in either group; however, patients in the low-dose group had lower 24-hour mean (SD) postoperative blood loss than the conventional group (545 (61) vs 680 (88) ml, p=0.001) and a reduced rate of transfusion of allogeneic blood (15% patients transfused vs 32%, p=0.01). An individually tailored low-dose heparin regimen for minimal cardiopulmonary bypass is safe and may be associated with reduced bleeding and lower transfusion requirements.
authors.affiliation: Laboratory of Experimental Physiology, Institute of Myology, Paris, France. y.fromes@institut-myologie.org
authors.forename: Y
authors.initials: Y
authors.lastname: Fromes
authors.forename: K
authors.initials: K
authors.lastname: Daghildjian
authors.forename: L
authors.initials: L
authors.lastname: Caumartin
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: I
authors.initials: I
authors.lastname: Rouquette
authors.forename: P
authors.initials: P
authors.lastname: Deleuze
authors.forename: O M
authors.initials: OM
authors.lastname: Bical
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000517:prevention & control / Q000628:therapy; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D006493:Heparin