Document Detail


Quantitative evaluation of heparin-coated versus non-heparin-coated bypass circuits during cardiopulmonary bypass.
MedLine Citation:
PMID:  10847956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The extracorporealization of blood activates various elements of the fibrinolytic, coagulation, and complement systems. It is theorized that advancements in biocompatibility ameliorate many of the changes leading to improved patient management. The purpose of this study was to determine if heparin-coated circuit (HCC) utilization during cardiopulmonary bypass enhances patient outcomes in a cost-effective manner. A search of the English medical literature was completed to identify all clinical, prospective, randomized trials comparing HCC and non-HCC in patients undergoing coronary artery bypass grafting or valvular surgery. Twenty-six papers consisting of a sample size of 1515 patients were identified and included in the study parameters. The study distinguished between Duraflo II and Carmeda coating techniques and matched papers with different heparin loading doses, as well as use of a heparin-coated cardiotomy. Study parameters were matched for all papers and analyzed according to the availability of data. Statistically significant benefits of HCC were found in postoperative blood loss, time in the ICU, end bypass C3a, time to extubation, end bypass lactoferrin, and end platelet count, but not with respect to postoperative chest tube drainage, red blood cell transfusions, and end bypass TAT complex, D-dimers, and BTG. Data comparing the use of coated or uncoated cardiotomy utilization failed to demonstrate a benefit to heparin coating. Several immunological variables were ameliorated when Carmeda HCC was utilized, although data were insufficient to establish a cost-benefit analysis. In conclusion, heparin-coated circuitry provided statistically better results when compared to noncoated circuitry.
Authors:
A H Stammers; K A Christensen; J Lynch; D P Zavadil; J J Deptula; R T Sydzyik
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis    
Journal Detail:
Title:  The Journal of extra-corporeal technology     Volume:  31     ISSN:  0022-1058     ISO Abbreviation:  J Extra Corpor Technol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  2000-04-28     Completed Date:  2000-04-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267637     Medline TA:  J Extra Corpor Technol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  135-41     Citation Subset:  T    
Affiliation:
Division of Clinical Perfusion Education, University of Nebraska Medical Center, Omaha 68198-5155, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiopulmonary Bypass / instrumentation*
Cost-Benefit Analysis
Equipment and Supplies / economics
Heparin*
Humans
Outcome Assessment (Health Care)
Prospective Studies
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
9005-49-6/Heparin

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


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