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The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 875-879, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Individual responses to heparinization for extracorporeal circulation

RH Friesen and AJ Clement

It has been proposed that wide variations in individual response to heparin lead to deficiencies in popular heparinization protocols for extracorporeal circulation (ECC). Thirty-nine patients undergoing open cardiac operations with ECC were anticoagulated with the heparinization protocol in use at St. Thomas' Hospital. The coagulation state was monitored with the blood activated recalcification time (BART) test. Wide variations in heparin dose-response and heparin activity-decay curves were observed. No patient was underheparinized, but many had markedly prolonged BART's. The total dose of heparin declined because BART monitoring allowed elimination of incremental heparin doses up to 180 minutes of ECC. Adequate reversal with protamine was achieved in all patients regardless of response to herparin. Alternative approaches for heparinization for ECC can be developed with the aid of rapid tests of the intraoperative coagulation state.


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D. R. Jobes, G. L. Aitken, and G. W. Shaffer
Increased accuracy and precision of heparin and protamine dosing reduces blood loss and transfusion patients undergoing primary cardiac operations
J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 36 - 45.
[Abstract] [Full Text]


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Copyright © 1976 by The American Association for Thoracic Surgery.