Heparin-coated circuits (Duraflo II) with reduced versus full anticoagulation during coronary artery bypass surgery.

摘要: Background: Introduction of completely heparin-coated cardiopulmonary bypass (CPB) circuits combined with reduced systemic anticoagulation has been shown to reduce postoperative bleeding and requirements for allogeneic transfusions after cardiac surgery. However, some uncertainty exists whether this effect is due the amount heparin or heparinized surface itself. Therefore, a retrospective study was undertaken, comparing two different protocols applied coronary artery patients treated identical CPB equipment. Method: Over 12 month period all operated extracorporeal circulation were subjected Duraflo II circuit (Baxter Healthcare Corp, Bentley Laboratories Division, Irvine, Calif) full dose (activated clotting time [ACT] > 480 seconds; Group F, n = 651). next 24 months, who an heparinization (ACT 250 seconds) included in R(n 675). Except protocols, treatment regimens before, during, operation remained unchanged throughout period. Results: There no statistically significant differences any major demographic operative parameters. In R, mean665 ± 257 mlversus757 367 mlin F(p < 0.0001), perioperative decrease hemoglobin concentration significantly lower R(22 1.2 gm/L versus 25 1.3 gm/L, p 0.0001). The ventilatory support shorter R (1.7 hours 1.9 1.1 0.0006), incidence new episodes atrial fibrillation (26.4% 32.8% F,p 0.01). incidences myocardial infarction, stroke, transient neurological disturbances, physical rehabilitation, mortality. No technical coagulation problems recorded either group. Conclusion: use coated loss compared treatment. addition, intubation low doses.(J Card Surg 2003;18:140-146)