CLINICAL HEPARIN-COATED CARDIOPULMONARY BYPASS - REDUCTION OF SYSTEMIC HEPARIN REQUIREMENTS FOR REDO CARDIAC-SURGERY

The authors compared blood loss, transfusion requirements, and heparin doses for reoperative cardiac surgery using either: a) a Duraflow (Ba xter Corporation, Irvine, CA) heparin coated cardiopulmonary bypass (C PB) system or b) standard CPB. Twenty patients underwent redo cardiac surgery white supported with heparin coated CPB, and 17 patients under went redo cardiac surgery with standard CPB. The following data are pr esented as mean +/- standard deviation. The heparin coated CPB circuit group received significantly less heparin than the standard CPB group (322 +/- 80 IU/kg versus 448 +/- 80 IU/kg, p < 0.01). There was no di fference in blood loss in the first 24 postoperative hrs or mean trans fusion requirements for the two groups. Despite the reduced dose of he parin, the mean activated clotting time in the heparin coated group wa s similar to the mean activated clotting time of the standard CPB grou p (577 +/- 98 sec versus 612 +/- 117 sec, p = ns). In conclusion, hepa rin coated CPB without reduced activated clotting time does not reduce transfusion requirements or blood loss in reoperative cardiac surgery . The heparin coated CPB system allows maintenance of the activated cl otting time level despite reduced heparin doses.