Heparin therapy during extracorporeal circulation. I. Problems inherent in existing heparin protocols.

B. S. Bull, R. A. Korpman, W. M. Huse, B. D. Briggs

Research output: Contribution to journalArticlepeer-review

Abstract

Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patients the half life of heparin and the sensitivity to heparin were measured. Knowledge of the patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.

Original languageAmerican English
Pages (from-to)674-684
Number of pages11
JournalThe Journal of thoracic and cardiovascular surgery
Volume69
Issue number5
DOIs
StatePublished - May 1 1975

ASJC Scopus Subject Areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Disciplines

  • Medicine and Health Sciences
  • Critical Care

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