TY - JOUR
T1 - Heparin-coated versus uncoated extracorporeal circuit in patients undergoing coronary artery bypass graft surgery
AU - Oliver, William C.
AU - Nuttall, Gregory A.
AU - Ereth, Mark H.
AU - Santrach, P. J.
AU - Buda, Daniel A.
AU - Schaff, Hartzell V.
N1 - Funding Information:
Supported by a grant from Baxter Healthcare Corporation.
PY - 2003/4
Y1 - 2003/4
N2 - 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. Design: Randomized, double-blind study. Setting: Tertiary-care academic medical center. Participants: Eighty-eight patients undergoing coronary artery bypass grafting requiring cardiopulmonary bypass (CPB) without previous sternotomy. Interventions: Subjects received either a heparin-coated or an uncoated extracorporeal circuit for CPB. Heparin, 300 μ/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. Measurements and Main 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.
AB - 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. Design: Randomized, double-blind study. Setting: Tertiary-care academic medical center. Participants: Eighty-eight patients undergoing coronary artery bypass grafting requiring cardiopulmonary bypass (CPB) without previous sternotomy. Interventions: Subjects received either a heparin-coated or an uncoated extracorporeal circuit for CPB. Heparin, 300 μ/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. Measurements and Main 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.
KW - And reduced heparinization
KW - Bleeding
KW - Cardiopulmonary bypass
KW - Coagulation
KW - Transfusion requirements
UR - http://www.scopus.com/inward/record.url?scp=0037393753&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037393753&partnerID=8YFLogxK
U2 - 10.1053/jcan.2003.41
DO - 10.1053/jcan.2003.41
M3 - Article
C2 - 12698396
AN - SCOPUS:0037393753
SN - 1053-0770
VL - 17
SP - 165
EP - 170
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 2
ER -