|A randomized study of coronary artery bypass surgery performed with the Resting Heart™ System utilizing a low vs a standard dosage of heparin.|
|PMID: 22914806 Owner: NLM Status: MEDLINE|
|OBJECTIVES: Allogeneic blood transfusion and reoperation for postoperative bleeding after the coronary artery bypass grafting have a negative impact on the patient outcome. This study aimed at evaluating the effects of reduced doses of heparin and protamine on the patient outcome, using a heparin-coated mini-cardiopulmonary bypass (CPB) system.
METHODS: Sixty patients undergoing elective first-time CPB were prospectively randomized either to have a reduced systemic heparinization [activated clotting time (ACT) = 250 s] or to a control group perfused with a full heparin dose (ACT = 420 s). Blood transfusions, ventilation time, early postoperative bleeding, ICU stay, reoperations for bleeding, postoperative cognitive status and the level of mobilization were registered.
RESULTS: Twenty-nine patients were randomized to the control group, 27 patients to the low-dose group and 4 patients were excluded because of protocol violations. Four patients in the control group received a total of 10 units of packed red blood cells, and in the low-dose group, no transfusions were given, P = 0.046. No patient was reoperated because of bleeding. The ICU stay was significantly shorter in the low-dose group (8.4 vs 13.7 h, P = 0.020), less dependent on oxygen on the first postoperative day (78 vs 97%, P = 0.034), better mobilized (89 vs 59%, P = 0.006) and had less pain (visual analogue scale 2.0 vs 3.5, P = 0.019) compared with the control group.
CONCLUSIONS: The use of a mini-CPB system combined with a low dose of heparin reduced the need for blood transfusions and may facilitate the faster mobilization of the patients.
|Johan Nilsson; Sara Scicluna; Gunnar Malmkvist; Leif Pierre; Lars Algotsson; Per Paulsson; Henrik Bjursten; Per Johnsson|
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|Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2012-08-21|
|Title: Interactive cardiovascular and thoracic surgery Volume: 15 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2012 Nov|
|Created Date: 2012-10-26 Completed Date: 2013-04-11 Revised Date: 2013-11-05|
Medline Journal Info:
|Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England|
|Languages: eng Pagination: 834-9 Citation Subset: IM|
|Department of Cardiothoracic Surgery, Cardiothoracic Anesthesia and Intensive Care, Skåne University Hospital and Lund University, 221 85 Lund, Sweden.|
|APA/MLA Format Download EndNote Download BibTex|
Anticoagulants / administration & dosage*, adverse effects
Cardiopulmonary Bypass / adverse effects, instrumentation*
Coated Materials, Biocompatible*
Coronary Artery Bypass / adverse effects, instrumentation*
Heparin / administration & dosage*, adverse effects
Heparin Antagonists / therapeutic use
Intensive Care Units
Length of Stay
Oxygen Inhalation Therapy
Pain, Postoperative / etiology, therapy
Postoperative Hemorrhage / etiology, therapy
Protamines / therapeutic use
Surgical Procedures, Elective
|0/Anticoagulants; 0/Coated Materials, Biocompatible; 0/Heparin Antagonists; 0/Protamines; 9005-49-6/Heparin|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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