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Thrombin generation during cardiopulmonary bypass using heparin-coated circuits or standard circuits
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Coagulation Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Thoracic Surgery)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Coagulation Research)
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
Abstract [en]

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.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-61476PubMedID: 8789468OAI: oai:DiVA.org:uu-61476DiVA: diva2:89387
Available from: 2008-10-17 Created: 2008-10-17 Last updated: 2010-01-11Bibliographically approved

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