A heparinised CPB system in patients with unstable angina. Coagulation , complement and cytokine cascade effects
(1996) In Scandinavian Journal of Thoracic and Cardiovascular Surgery 30(SUPPL. 44). p.56-56- Abstract
PURPOSE: To investigate assumed benefits of heparin coated cardiopulmonary bypass systems from standard non-coated CBP systems in unstable angina patients with preoperative heparinisation. STUDY DESIGN: Coagulation, complement, cytokine and Sonoclot parameters, were analyzed before total heparinisation prior to surgery, during cardiopulmonary bypass, after protamine to 48 hours after surgery. MATERIALS & METHODS: Twenty patients were randomized to either recieve a Bentley-Baxter Duraflo II heparin coated CBP-system (10 patients) or a non-coated Baxter system (10 patients). ACT-levels were kept over 480 sees in both groups with a with a schematic anticoagulation regime according to: 1. an initial 300 IU/kg BW heparin dose; 2. if... (More)
PURPOSE: To investigate assumed benefits of heparin coated cardiopulmonary bypass systems from standard non-coated CBP systems in unstable angina patients with preoperative heparinisation. STUDY DESIGN: Coagulation, complement, cytokine and Sonoclot parameters, were analyzed before total heparinisation prior to surgery, during cardiopulmonary bypass, after protamine to 48 hours after surgery. MATERIALS & METHODS: Twenty patients were randomized to either recieve a Bentley-Baxter Duraflo II heparin coated CBP-system (10 patients) or a non-coated Baxter system (10 patients). ACT-levels were kept over 480 sees in both groups with a with a schematic anticoagulation regime according to: 1. an initial 300 IU/kg BW heparin dose; 2. if necessary being repeated; 3. then ensued by plasma 2 + 2 units; 4. a third dose of heparin (300 ID/kg BW) was then administered; and finally 5. antithrombin concentrate was administered if ACT still level remained below 480 s. RESULTS: Soluble fibrin (s-fibrin) and thrombin-antithrombin complex (TAT) indicated an ongoing activation in spite of the preoperative heparinanticoagulation in unstable angina patients. Intaoperative analyses with both these assays indicated significantly lower thrombin activation with a heparin coated CBP-system. The results of the complement, cytokine and platelet function analyzes and clinical data evaluation will be presented at the meeting. CONCLUSION: A heparin coated cardiopulmonary bypass system induced less activation of the coagulation cascade in unstable angina patients. This could forward a reduction of heparin and reduced need for plasma /antihrombin in patients with unstable angina - increased rise for heparin resistance during CBP- when a heparin coated CBP-system is used, but remains to be studied.
(Less)
- author
- Kronlund, P. ; Schött, U. LU ; Egberg, N ; Vikerfors, T. and Hansson, L. O.
- publishing date
- 1996
- type
- Contribution to journal
- publication status
- published
- in
- Scandinavian Journal of Thoracic and Cardiovascular Surgery
- volume
- 30
- issue
- SUPPL. 44
- pages
- 1 pages
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:33747701568
- ISSN
- 0036-5580
- project
- Koagulation vid kirurgi och kritisk sjukdom
- language
- English
- LU publication?
- no
- id
- 687e5a55-7a41-438f-a1fe-f8550f50068f
- date added to LUP
- 2017-07-27 10:41:40
- date last changed
- 2022-01-30 21:48:17
@article{687e5a55-7a41-438f-a1fe-f8550f50068f, abstract = {{<p>PURPOSE: To investigate assumed benefits of heparin coated cardiopulmonary bypass systems from standard non-coated CBP systems in unstable angina patients with preoperative heparinisation. STUDY DESIGN: Coagulation, complement, cytokine and Sonoclot parameters, were analyzed before total heparinisation prior to surgery, during cardiopulmonary bypass, after protamine to 48 hours after surgery. MATERIALS & METHODS: Twenty patients were randomized to either recieve a Bentley-Baxter Duraflo II heparin coated CBP-system (10 patients) or a non-coated Baxter system (10 patients). ACT-levels were kept over 480 sees in both groups with a with a schematic anticoagulation regime according to: 1. an initial 300 IU/kg BW heparin dose; 2. if necessary being repeated; 3. then ensued by plasma 2 + 2 units; 4. a third dose of heparin (300 ID/kg BW) was then administered; and finally 5. antithrombin concentrate was administered if ACT still level remained below 480 s. RESULTS: Soluble fibrin (s-fibrin) and thrombin-antithrombin complex (TAT) indicated an ongoing activation in spite of the preoperative heparinanticoagulation in unstable angina patients. Intaoperative analyses with both these assays indicated significantly lower thrombin activation with a heparin coated CBP-system. The results of the complement, cytokine and platelet function analyzes and clinical data evaluation will be presented at the meeting. CONCLUSION: A heparin coated cardiopulmonary bypass system induced less activation of the coagulation cascade in unstable angina patients. This could forward a reduction of heparin and reduced need for plasma /antihrombin in patients with unstable angina - increased rise for heparin resistance during CBP- when a heparin coated CBP-system is used, but remains to be studied.</p>}}, author = {{Kronlund, P. and Schött, U. and Egberg, N and Vikerfors, T. and Hansson, L. O.}}, issn = {{0036-5580}}, language = {{eng}}, number = {{SUPPL. 44}}, pages = {{56--56}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Journal of Thoracic and Cardiovascular Surgery}}, title = {{A heparinised CPB system in patients with unstable angina. Coagulation , complement and cytokine cascade effects}}, volume = {{30}}, year = {{1996}}, }