PORCINE HEPARIN INCREASES POSTOPERATIVE BLEEDING IN CARDIOPULMONARY BYPASS PATIENTS

被引:5
作者
IVERSON, LIG [1 ]
DUHAYLONGSOD, FG [1 ]
YOUNG, JN [1 ]
ECKER, RR [1 ]
ENNIX, CL [1 ]
MORETTI, RL [1 ]
FARRAR, M [1 ]
HAYES, R [1 ]
LEE, J [1 ]
MAY, IA [1 ]
机构
[1] SAMUEL MERRITT HOSP,DEPT CARDIOTHORAC SURG,OAKLAND,CA
关键词
cardiopulmonary bypass; heparin; platelet aggregation; postoperative bleeding; protamine; thrombocytopenia;
D O I
10.1007/BF01857644
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
One hundred thirteen patients undergoing cardiopulmonary bypass were randomly assigned to receive either bovine or porcine heparin. Heparin was infused at 4.5 mg/kg during bypass and administered at the lesser of 70 units/kg or 5000 units/dose at 12-hour intervals postoperatively. Platelet counts decreased to 45% of preoperative levels during the first 3 days postoperatively (porcine, 44±13%, n =50; bovine, 46±15%), but returned to preoperative levels by the seventh postoperative day. The average blood loss in the porcine heparin group significantly exceeded that of the bovine heparin group (porcine, 1350.7±727.8 ml; bovine, 1059.6±381.0 ml; p<.01). Consequently, the platelet transfusion requirement was greater in the porcine heparin group (porcine, 1.7±3.9 units; bovine, 0.5±1.7 units; p<.05); however, blood and blood component (with the exception of platelets) administration was not significantly different between the two groups. The four patients taking anticoagulants or antiinflammatory agents in the porcine group required a mean of 8.5 units of red blood cells (RBC) plus supplemental platelets. The seven such patients in the bovine group received a mean of 3.0 units of RBC and no platelets. Thus, the use of porcine heparin resulted in a generalized increase in postoperative bleeding with increased management problems in patients undergoing cardiopulmonary bypass. © 1990 Kluwer Academic Publishers.
引用
收藏
页码:269 / 272
页数:4
相关论文
共 17 条
[1]  
Parker-Willia E.J., Platelets in prosthesis and pumps, Clin Haematol, 1, (1972)
[2]  
Gollub S., Ulin A.W., Heparin induced thrombocytopenia in man, J Lab Clin Med, 59, pp. 430-434, (1962)
[3]  
Jkeub H.G., Bell W.R., Disseminated intravascular coagulation during heparin therapy, Ann Intern Med, 80, pp. 477-481, (1974)
[4]  
Bell W.R., Royall R.M., Heparin-associated thrombocytopenia: A comparison of three heparin preparations, N Engl J Med, 303, pp. 902-907, (1980)
[5]  
Eika C., On the mechanism of platelet aggregation induced by heparin, protamine and polybrene, Scand J Hacmatol, 9, (1972)
[6]  
Thompson C., Forbes C.D., Martin E., Et al., Potentiation of the platelet aggregation and adhesion by heparin both in vivo and in vitro, Clin Sci, 44, (1973)
[7]  
McKenna R., Backman F., Whittaker B., Et al., The hemostatic mechanism after open heart surgery II. Frequency of abnormal platelet functions during and after extracorporeal circulation, J Thorac Cardiorasc Surg, 70, pp. 298-308, (1975)
[8]  
O'Brian J.R., Etherington M., Jamieson S., Refractory state of platelet aggregation with major operations, Lancet, 2, pp. 741-743, (1971)
[9]  
Pike O.M., Marquiss J.E., Weiner R.S., Et al., A study of platelet counts during cardiopulmonary bypass, Transfusion, 12, pp. 119-121, (1972)
[10]  
Schmidt P.J., Peden J.C., Brecker G., Et al., Thrombocytopenia and bleeding tendency after extracorporeal circulation, N Engl J Med, 265, pp. 1181-1185, (1961)