Advanced

A heparinised CPB system in patients with unstable angina. Coagulation , complement and cytokine cascade effects

Kronlund, P.; Schött, U. LU ; Egberg, N; Vikerfors, T. and Hansson, L. O. (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)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
in
Scandinavian Journal of Thoracic and Cardiovascular Surgery
volume
30
issue
SUPPL. 44
pages
1 pages
publisher
Scandinavian University Press
external identifiers
  • scopus:33747701568
ISSN
0036-5580
language
English
LU publication?
no
id
687e5a55-7a41-438f-a1fe-f8550f50068f
date added to LUP
2017-07-27 10:41:40
date last changed
2017-07-27 10:41:40
@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 &amp; 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    = {Scandinavian University Press},
  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},
}