Document Detail


A randomized study of coronary artery bypass surgery performed with the Resting Heart™ System utilizing a low vs a standard dosage of heparin.
MedLine Citation:
PMID:  22914806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Johan Nilsson; Sara Scicluna; Gunnar Malmkvist; Leif Pierre; Lars Algotsson; Per Paulsson; Henrik Bjursten; Per Johnsson
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-08-21
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Nov 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  834-9     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Cardiothoracic Anesthesia and Intensive Care, Skåne University Hospital and Lund University, 221 85 Lund, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / administration & dosage*,  adverse effects
Blood Transfusion
Cardiopulmonary Bypass / adverse effects,  instrumentation*
Coated Materials, Biocompatible*
Cognition
Coronary Artery Bypass / adverse effects,  instrumentation*
Equipment Design
Female
Heparin / administration & dosage*,  adverse effects
Heparin Antagonists / therapeutic use
Humans
Intensive Care Units
Length of Stay
Male
Middle Aged
Mobility Limitation
Oxygen Inhalation Therapy
Pain, Postoperative / etiology,  therapy
Postoperative Hemorrhage / etiology,  therapy
Prospective Studies
Protamines / therapeutic use
Reoperation
Respiration, Artificial
Surgical Procedures, Elective
Sweden
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Coated Materials, Biocompatible; 0/Heparin Antagonists; 0/Protamines; 9005-49-6/Heparin
Comments/Corrections

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


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