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CARDIOVASCULAR
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Volume 5, 2000, No 1 |
Heparin
Coated Extracorporeal Circulation and Low Dose Heparinization: Technical
Considerations and Specific Risks
N. Mirow, K. Minami, N. Reiss, H. Knobl, K. Kind, R. Körfer
Clinical feasibility of a heparin coated cardiopulmonary bypass system combined with reduced systemic heparinization in coronary bypass surgery was investigated in a prospective, randomized clinical study. 119 patients (pts.) were divided into 3 groups: group A (n=39) had a standard uncoated ECC-set and systemic heparin was administered in an initial dose of 400 IE/kg body weight. During ECC activated clotting time (ACT) was kept ³ 480 sec. Group B (n=42) had the same ECC-set completely coated with low molecular weight heparin, i.v. heparin was given in the same dose as in group A, ACT was kept at the same level. Group C (n=38) had the same coated ECC set than group B, but i.v. heparin was reduced to 150 IE/kg and during ECC ACT was set to be ³ 240 sec. The same circulatory components were used in all 3 groups including roller pumps, coronary suction and an open cardiotomy reservoir.
In the postoperative clinical course cardiac, neurological and other organ dysfunctions were not significantly different between groups.
We conclude that up-to-date heparin coated cardiopulmonary bypass combined with reduced systemic heparinization can be safely used employing the same standard equipment and procedures as in uncoated technology.
Key words: cardiopulmonary bypass, extracorporeal circulation, heparin-coating, low-molecular-weight heparin, systemic heparinization, coronary bypass surgery
Address for Correspondence:
Nikolas Mirow, M.D.
Dept. of Thoracic and Cardiovascular Surgery
Heart Center NRW, Ruhr University of Bochum
Georgstr. 11
D-32545 Bad Oeynhausen
Germany
E-mail: nmirow@hdz-nrw.de
Reference:
(CVE. 2000; 5 (1): 11-15)
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