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A comparison of low vs conventional‐dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery
Author(s) -
Fromes Y.,
Daghildjian K.,
Caumartin L.,
Fischer M.,
Rouquette I.,
Deleuze P.,
Bical O. M.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06709.x
Subject(s) - medicine , heparin , cardiopulmonary bypass , regimen , anesthesia , extracorporeal , activated clotting time , artery , surgery , bypass grafting , blood transfusion
Summary The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high‐dose anticoagulation with a low‐dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred patients who received 300 IU.kg −1 heparin were compared with 68 patients who received heparin according to an individually adjusted activated coagulation time target of 300 s, resulting in a mean (SD) heparin dose of 145 (30) IU.kg −1 . There were no thromboembolic events in either group; however, patients in the low‐dose group had lower 24‐hour mean (SD) postoperative blood loss than the conventional group (545 (61) vs 680 (88) ml, p = 0.001) and a reduced rate of transfusion of allogeneic blood (15% patients transfused vs 32%, p = 0.01). An individually tailored low‐dose heparin regimen for minimal cardiopulmonary bypass is safe and may be associated with reduced bleeding and lower transfusion requirements.