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Titolo:
RISK AND BENEFIT OF LOW SYSTEMIC HEPARINIZATION DURING OPEN-HEART OPERATIONS
Autore:
VONSEGESSER LK; WEISS BM; PASIC M; GARCIA E; TURINA MI;
Indirizzi:
UNIV ZURICH HOSP,CARDIOVASC SURG CLIN,RUMISTR 100 CH-8091 ZURICH SWITZERLAND UNIV ZURICH HOSP,INST ANESTHESIOL CH-8091 ZURICH SWITZERLAND
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 2, volume: 58, anno: 1994,
pagine: 391 - 398
SICI:
0003-4975(1994)58:2<391:RABOLS>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOPULMONARY BYPASS; ANTICOAGULATION; REQUIREMENTS; COAGULATION; ELIMINATION; PERFUSION; TIME;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
L.K. Vonsegesser et al., "RISK AND BENEFIT OF LOW SYSTEMIC HEPARINIZATION DURING OPEN-HEART OPERATIONS", The Annals of thoracic surgery, 58(2), 1994, pp. 391-398

Abstract

Heparin surface-coated perfusion equipment with improved thromboresistance was evaluated in 104 consecutive patients undergoing open heart operation in a prospective, randomized trial with low versus full systemic heparinization. Surgical procedures included coronary artery revascularization in 47 of 54 (87%) for low versus 44 of 50 patients (88%;not significant [NS]) for full, valve repair/replacement in 8 of 54 (15%) for low versus 5 of 50 patients (10%; NS) for full, left ventricular aneurysm repair in 1 of 54 (2%) for low versus 2 of 50 patients (4%; NS) for full, and other in 3 of 54 (6%) for low versus 3 of 50 patients (6%; NS) for full. Cross-clamp time was 39.2 +/- 10.7 minutes forlow versus 39.5 +/- 10.5 minutes for full (NS). Cardiopulmonary bypass time was 68.6 +/- 20.1 minutes for low versus 69.3 +/- 16.6 minutes for full (NS). Lowest activated coagulation time during perfusion was 255 +/- 75 seconds for low versus 537 +/- 205 seconds for full (p < 0.0005). In the low group, the target activated coagulation time of morethan 180 seconds was not reached during perfusion in 4 of 54 patients(7%), the lowest value being 164 seconds. No oxygenator failure occurred. Hospital mortality was 0 of 54 (0%) for low versus 1 of 50 patients (2%) for full (NS). Bleeding required surgical revision in 0 of 54 (0%) for low versus 4 of 50 patients (8%) for full (p = 0.05). Drainage (24 hours) was 790 +/- 393 mL for low versus 1,039 +/- 732 mL for full (p < 0.025). Amount of packed homologous red cells transfused (24 hours) was 300 +/- 354 mt for low versus 957 +/- 596 mL for full (p < 0.0005). Baseline hematocrit of 43.3% +/- 3.7% for low versus 43.0% +/-3.9% (NS) for full before operation moved to 28.9% +/- 3.2% far low versus 28.8% +/- 3.2% for full (NS) at 24 hours. Low systemic heparinization during open heart operation results in reduced blood loss and transfusion requirements.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 21:05:25