Thrombin generation during cardiopulmonary bypass using heparin-coated circuits or standard circuits
1995 (English)In: Scandinavian journal of thoracic and cardiovascular surgery, ISSN 0036-5580, Vol. 29, no 4, 157-165 p.Article, book review (Other academic) Published
For quantitative comparison of thrombin generation during cardiopulmonary bypass (CPB) with heparin-coated vs conventional CPB circuits, thrombin-antithrombin III complex (TAT) and prothrombin fragment 1 + 2 (F1 + 2) were analyzed in 20 patients undergoing combined heart valve surgery and coronary artery bypass grafting (CABG), in ten cases with heparin-coated circuits (COMB-HC) and in ten with standard circuits (COMB-C). Extensive thrombin generation was found in both groups, with maximal TAT and F1 + 2 levels at the end of CPB. Of 15 operations with only CABG, seven were performed with heparin-coated circuits and heparin dose 40% of normal (CABG-HC), and eight with standard circuits and normal heparin doses (CABG-C). TAT was maximal at the end of CPB and F1 + 2 peaked 3 hours after protamine injection. At the end of CPB both levels were significantly higher in the CABG-HC than in the CABG-C group, though thrombin generation was less than in the COMB groups. The abundant thrombin generation during CPB thus was much more pronounced during complex operations. Use of heparin-coated circuits did not reduce thrombin generation, which was increased by 60% reduction of the systemic heparin dose. The clinical implications are still unknown, as no complications were observed.
Place, publisher, year, edition, pages
1995. Vol. 29, no 4, 157-165 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-61476PubMedID: 8789468OAI: oai:DiVA.org:uu-61476DiVA: diva2:89387