TY - JOUR
T1 - The antithrombin III-saving effect of reduced systemic heparinization and heparin-coated circuits
AU - Ranucci, Marco
AU - Cazzaniga, Anna
AU - Soro, Giorgio
AU - Isgrò, Giuseppe
AU - Frigiola, Alessandro
AU - Menicanti, Lorenzo
PY - 2002
Y1 - 2002
N2 - Objective: To investigate the perioperative changes of antithrombin III (AT-III) activity using reduced systemic heparinization and the possible role of AT-III in determining a better postoperative outcome. Design: Prospective randomized study. Setting: University hospital. Participants: Patients undergoing elective coronary revascularization with cardiopulmonary bypass (n = 90). Interventions: Of patients, 30 were treated with heparin-coated circuits and reduced systemic heparinization; 30, with heparin-coated circuits and full systemic heparinization; 30, with conventional circuits and full systemic heparinization. Measurements and Main Results: Heparin-coated circuits with full systemic heparinization did not exert any effect on coagulation parameters. Low systemic heparinization resulted in a significantly (p <0.01) higher hematocrit value on arrival in the intensive care unit and in significantly higher values of AT-III activity during cardiopulmonary bypass (66 ± 12% v 57.4 ± 13% and 59.1 ± 12% in the full systemic heparinization groups; p <0.05), on arrival in the intensive care unit (69.7 ± 13% v 60.7 ± 13% and 60.8 ± 11% in the full systemic heparinization groups; p <0.01), and on the first postoperative day (81.3 ± 15% v 67.4 ± 13% and 70.2 ± 12% in the full systemic heparinization groups; p <0.01). No differences were observed in the clinical outcome. Conclusion: Reducing systemic heparinization determines an AT-III-saving effect that could be responsible for the decrease in thromboembolic complications already observed by other authors. It induces higher hematocrit levels immediately after the operation, probably reducing the unmeasurable intraoperative blood loss.
AB - Objective: To investigate the perioperative changes of antithrombin III (AT-III) activity using reduced systemic heparinization and the possible role of AT-III in determining a better postoperative outcome. Design: Prospective randomized study. Setting: University hospital. Participants: Patients undergoing elective coronary revascularization with cardiopulmonary bypass (n = 90). Interventions: Of patients, 30 were treated with heparin-coated circuits and reduced systemic heparinization; 30, with heparin-coated circuits and full systemic heparinization; 30, with conventional circuits and full systemic heparinization. Measurements and Main Results: Heparin-coated circuits with full systemic heparinization did not exert any effect on coagulation parameters. Low systemic heparinization resulted in a significantly (p <0.01) higher hematocrit value on arrival in the intensive care unit and in significantly higher values of AT-III activity during cardiopulmonary bypass (66 ± 12% v 57.4 ± 13% and 59.1 ± 12% in the full systemic heparinization groups; p <0.05), on arrival in the intensive care unit (69.7 ± 13% v 60.7 ± 13% and 60.8 ± 11% in the full systemic heparinization groups; p <0.01), and on the first postoperative day (81.3 ± 15% v 67.4 ± 13% and 70.2 ± 12% in the full systemic heparinization groups; p <0.01). No differences were observed in the clinical outcome. Conclusion: Reducing systemic heparinization determines an AT-III-saving effect that could be responsible for the decrease in thromboembolic complications already observed by other authors. It induces higher hematocrit levels immediately after the operation, probably reducing the unmeasurable intraoperative blood loss.
KW - Antithrombin III (AT-III)
KW - Cardiopulmonary bypass (CPB)
KW - Heparin
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U2 - 10.1053/jcan.2002.124140
DO - 10.1053/jcan.2002.124140
M3 - Article
C2 - 12073203
AN - SCOPUS:0036017628
VL - 16
SP - 316
EP - 320
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 3
ER -