Document Detail


Heparin and antithrombin III levels during cardiopulmonary bypass: correlation with subclinical plasma coagulation.
MedLine Citation:
PMID:  7944706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The anticoagulant effect of heparin in the milieu of altered antithrombin III levels was investigated in adult (n = 7) and pediatric (n = 14) patients undergoing open heart operations. The pediatric patients were subdivided into a control group (n = 8) and an antithrombin III group (n = 6), which received 1,000 units of antithrombin III. The reduction in antithrombin III levels during cardiopulmonary bypass was obvious in patients of all ages, showing a greater reduction (although not statistically significant) in the pediatric patients. However, the antithrombin III group patients maintained their preoperative levels of antithrombin III. The elevated fibrinopeptide A levels in pediatric and adult control group patients suggested that considerable subclinical plasma coagulation occurred during open heart operations, especially during the normothermic period of cardiopulmonary bypass and after the administration of protamine. Antithrombin III levels in the children were the most predictive (r = -0.58; p < 0.001) for production of fibrinopeptide A during moderate hypothermic cardiopulmonary bypass, but the heparin levels were most predictive (r = -0.57, p < 0.03) in the adults. This result may be related to the different actions of heparin when antithrombin III levels are reduced. Supplementation with antithrombin III succeeded in suppressing the activation of the coagulation cascade and resulted in no statistical change in fibrinopeptide A levels at any time. We conclude that heparin and (in some patients) antithrombin III levels are important variables for the inhibition of fibrin formation and the possible preservation of coagulation proteins.
Authors:
K Hashimoto; M Yamagishi; T Sasaki; M Nakano; H Kurosawa
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  58     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1994-10-31     Completed Date:  1994-10-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  799-804; discussion 804-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Antithrombin III / analysis*,  pharmacology
Blood Coagulation / drug effects
Cardiopulmonary Bypass*
Child, Preschool
Fibrinopeptide A / analysis*,  drug effects
Hematocrit
Heparin / blood*,  pharmacology
Humans
Hypothermia, Induced
Infant
Intraoperative Care*
Middle Aged
Predictive Value of Tests
Preoperative Care
Protamines / pharmacology
Whole Blood Coagulation Time
Chemical
Reg. No./Substance:
0/Protamines; 25422-31-5/Fibrinopeptide A; 9000-94-6/Antithrombin III; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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