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A randomized study of coronary artery bypass surgery performed with the Resting Heart™ System utilizing a low vs a standard dosage of heparin.

Nilsson, Johan LU ; Scicluna, Sara LU ; Malmkvist, Gunnar LU ; Pierre, Leif; Algotsson, Lars LU ; Paulsson, Per LU ; Bjursten, Henrik LU and Johnsson, Per (2012) In Interactive Cardiovascular and Thoracic Surgery 15(5). p.834-839
Abstract
OBJECTIVES:

Allogeneic blood transfusion and reoperation for postoperative bleeding after the coronary artery bypass grafting have a negative impact on the patient outcome. This study aimed at evaluating the effects of reduced doses of heparin and protamine on the patient outcome, using a heparin-coated mini-cardiopulmonary bypass (CPB) system.



METHODS:

Sixty patients undergoing elective first-time CPB were prospectively randomized either to have a reduced systemic heparinization [activated clotting time (ACT) = 250 s] or to a control group perfused with a full heparin dose (ACT = 420 s). Blood transfusions, ventilation time, early postoperative bleeding, ICU stay, reoperations for bleeding,... (More)
OBJECTIVES:

Allogeneic blood transfusion and reoperation for postoperative bleeding after the coronary artery bypass grafting have a negative impact on the patient outcome. This study aimed at evaluating the effects of reduced doses of heparin and protamine on the patient outcome, using a heparin-coated mini-cardiopulmonary bypass (CPB) system.



METHODS:

Sixty patients undergoing elective first-time CPB were prospectively randomized either to have a reduced systemic heparinization [activated clotting time (ACT) = 250 s] or to a control group perfused with a full heparin dose (ACT = 420 s). Blood transfusions, ventilation time, early postoperative bleeding, ICU stay, reoperations for bleeding, postoperative cognitive status and the level of mobilization were registered.



RESULTS:

Twenty-nine patients were randomized to the control group, 27 patients to the low-dose group and 4 patients were excluded because of protocol violations. Four patients in the control group received a total of 10 units of packed red blood cells, and in the low-dose group, no transfusions were given, P = 0.046. No patient was reoperated because of bleeding. The ICU stay was significantly shorter in the low-dose group (8.4 vs 13.7 h, P = 0.020), less dependent on oxygen on the first postoperative day (78 vs 97%, P = 0.034), better mobilized (89 vs 59%, P = 0.006) and had less pain (visual analogue scale 2.0 vs 3.5, P = 0.019) compared with the control group.



CONCLUSIONS:

The use of a mini-CPB system combined with a low dose of heparin reduced the need for blood transfusions and may facilitate the faster mobilization of the patients. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac surgery, Mini cardiopulmonary bypass, Heparin
in
Interactive Cardiovascular and Thoracic Surgery
volume
15
issue
5
pages
834 - 839
publisher
European Association of Cardio-Thoracic Surgery
external identifiers
  • wos:000310224000008
  • pmid:22914806
  • scopus:84869173825
ISSN
1569-9285
DOI
10.1093/icvts/ivs345
language
English
LU publication?
yes
id
62b03dae-34c8-4892-b7f5-ed258baa4cbd (old id 3047298)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22914806?dopt=Abstract
date added to LUP
2012-09-05 20:39:09
date last changed
2017-01-01 03:34:52
@article{62b03dae-34c8-4892-b7f5-ed258baa4cbd,
  abstract     = {OBJECTIVES:<br/><br>
Allogeneic blood transfusion and reoperation for postoperative bleeding after the coronary artery bypass grafting have a negative impact on the patient outcome. This study aimed at evaluating the effects of reduced doses of heparin and protamine on the patient outcome, using a heparin-coated mini-cardiopulmonary bypass (CPB) system.<br/><br>
<br/><br>
METHODS:<br/><br>
Sixty patients undergoing elective first-time CPB were prospectively randomized either to have a reduced systemic heparinization [activated clotting time (ACT) = 250 s] or to a control group perfused with a full heparin dose (ACT = 420 s). Blood transfusions, ventilation time, early postoperative bleeding, ICU stay, reoperations for bleeding, postoperative cognitive status and the level of mobilization were registered.<br/><br>
<br/><br>
RESULTS:<br/><br>
Twenty-nine patients were randomized to the control group, 27 patients to the low-dose group and 4 patients were excluded because of protocol violations. Four patients in the control group received a total of 10 units of packed red blood cells, and in the low-dose group, no transfusions were given, P = 0.046. No patient was reoperated because of bleeding. The ICU stay was significantly shorter in the low-dose group (8.4 vs 13.7 h, P = 0.020), less dependent on oxygen on the first postoperative day (78 vs 97%, P = 0.034), better mobilized (89 vs 59%, P = 0.006) and had less pain (visual analogue scale 2.0 vs 3.5, P = 0.019) compared with the control group.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
The use of a mini-CPB system combined with a low dose of heparin reduced the need for blood transfusions and may facilitate the faster mobilization of the patients.},
  author       = {Nilsson, Johan and Scicluna, Sara and Malmkvist, Gunnar and Pierre, Leif and Algotsson, Lars and Paulsson, Per and Bjursten, Henrik and Johnsson, Per},
  issn         = {1569-9285},
  keyword      = {Cardiac surgery,Mini cardiopulmonary bypass,Heparin},
  language     = {eng},
  number       = {5},
  pages        = {834--839},
  publisher    = {European Association of Cardio-Thoracic Surgery},
  series       = {Interactive Cardiovascular and Thoracic Surgery},
  title        = {A randomized study of coronary artery bypass surgery performed with the Resting Heart™ System utilizing a low vs a standard dosage of heparin.},
  url          = {http://dx.doi.org/10.1093/icvts/ivs345},
  volume       = {15},
  year         = {2012},
}