| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1996;62:1128-1133
© 1996 The Society of Thoracic Surgeons
Departments of Cardiac Surgery and Anesthesiology, Oslo Heart Center, Oslo, Norway
Accepted for publication May 6, 1996.
Background. The use of completely heparin coated cardiopulmonary bypass circuits in combination with a reduced systemic heparin dose has previously been shown to reduce postoperative bleeding after cardiac operations. However, it has remained unknown whether this effect was related to the improved biocompatibility of the heparin-treated surfaces per se or to the reduced exposure to circulating heparin. Therefore we investigated patients undergoing heparin-coated extracorporeal circulation and full systemic heparinization.
Methods. Two hundred seventeen patients having first-time myocardial revascularization were prospectively randomized either to a group in which a completely ("tip-to-tip") heparin-coated circuit (Duraflo II) was used for perfusion (n = 107) or to a control group (n = 110) in which an uncoated, but otherwise identical, circuit was used. Full systemic heparinization was induced in both groups (activated clotting time, >480 seconds). The postoperative blood loss, requirements for homologous blood transfusions, clinical performance, and complications were recorded.
Results. The amount of postoperative mediastinal drainage was nearly identical in the two groups. The mean 18-hour drainage was 694 ± 313 mL in the heparin-coated group and 679 ± 269 mL in the control group (p = not significant). Three patients in the heparin-coated group and 6 patients in the control group received homologous red blood cell transfusions (p = not significant). The incidence of postoperative atrial fibrillation was significantly lower in the heparin-coated group (21.8%) than in the control group (43.1%) (p = 0.002). Otherwise, there were no significant differences in the extubation times, the incidence of perioperative myocardial infarction, the creatinine concentration, the incidence of neurologic dysfunction, the progress in physical rehabilitation, or the hemoglobin concentration at discharge.
Conclusions. The use of completely heparin coated cardiopulmonary bypass circuits and full systemic heparinization in patients undergoing coronary artery bypass procedures did not reduce postoperative bleeding or change clinical performance, except for a significant decrease in the incidence of postoperative atrial fibrillation.
This article has been cited by other articles:
|
|
 |
|
  M. Ranucci, S. Aronson, W. Dietrich, C. M. Dyke, A. Hofmann, K. Karkouti, M. Levi, G. J. Murphy, F. W. Sellke, L. Shore-Lesserson, et al. Patient blood management during cardiac surgery: Do we have enough evidence for clinical practice? J. Thorac. Cardiovasc. Surg., August 1, 2011; 142(2): 249.e1 - 249.e32. [Full Text] [PDF]
|
|
|
|
 |
|
 O. Mangoush, S. Purkayastha, S. Haj-Yahia, J. Kinross, M. Hayward, F. Bartolozzi, A. Darzi, and T. Athanasiou Heparin-bonded circuits versus nonheparin-bonded circuits: an evaluation of their effect on clinical outcomes Eur J Cardiothorac Surg, June 1, 2007; 31(6): 1058 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Jessen Pro: Heparin-Coated Circuits Should be Used for Cardiopulmonary Bypass Anesth. Analg., December 1, 2006; 103(6): 1365 - 1369. [Full Text] [PDF]
|
|
|
|
 |
|
 F D Rubens and T Mesana The inflammatory response to cardiopulmonary bypass: a therapeutic overview Perfusion, January 1, 2004; 19(1_suppl): S5 - S12. [Abstract] [PDF]
|
|
|
|
 |
|
 G. M. Palatianos, C. N. Foroulis, M. I. Vassili, G. Astras, K. Triantafillou, E. Papadakis, A. A. Lidoriki, E. Iliopoulou, and E. N. Melissari A prospective, double-blind study on the efficacy of the bioline surface-heparinized extracorporeal perfusion circuit Ann. Thorac. Surg., July 1, 2003; 76(1): 129 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. D. Rubens and T. Mesana Surface Modified Cardiopulmonary Bypass Circuits: Modifying the Inflammatory Response Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2002; 6(4): 301 - 306. [Abstract] [PDF]
|
|
|
|
|
|
M. Johnell, G. Elgue, R. Larsson, A. Larsson, S. Thelin, and A. Siegbahn Coagulation, fibrinolysis, and cell activation in patients and shed mediastinal blood during coronary artery bypass grafting with a new heparin-coated surface J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 321 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. A. Hennein Inflammation After Cardiopulmonary Bypass: Therapy for the Postpump Syndrome Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 236 - 255. [Abstract] [PDF]
|
|
|
|
|
|
E. Ovrum, G. Tangen, R. Oystese, M. A. L. Ringdal, and R. Istad Comparison of two heparin-coated extracorporeal circuits with reduced systemic anticoagulation in routine coronary artery bypass operations J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0324 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kumano, S. Suehiro, K. Hattori, T. Shibata, Y. Sasaki, M. Hosono, and H. Kinoshita Coagulofibrinolysis during heparin-coated cardiopulmonary bypass with reduced heparinization Ann. Thorac. Surg., October 1, 1999; 68(4): 1252 - 1256. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. McCarthy, J.-P. P. Yared, R. C. Foster, D. A. Ogella, J. A. Borsh, and D. M. Cosgrove III A prospective randomized trial of Duraflo II heparin-coated circuits in cardiac reoperations Ann. Thorac. Surg., May 1, 1999; 67(5): 1268 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Hyde, J. A Chinn, and T. R Graham Platelets and cardiopulmonary bypass Perfusion, December 1, 1998; 13(6): 389 - 407. [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
