The antithrombin III-saving effect of reduced systemic heparinization and heparin-coated circuits

Marco Ranucci, Anna Cazzaniga, Giorgio Soro, Giuseppe Isgrò, Alessandro Frigiola, Lorenzo Menicanti

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)316-320
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume16
Issue number3
DOIs
Publication statusPublished - 2002

Keywords

  • Antithrombin III (AT-III)
  • Cardiopulmonary bypass (CPB)
  • Heparin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'The antithrombin III-saving effect of reduced systemic heparinization and heparin-coated circuits'. Together they form a unique fingerprint.

Cite this