SAFE USE OF HEPARIN-COATED BYPASS CIRCUITS INCORPORATING A PUMP-OXYGENATOR

Durable, covalently bonded, heparin-coated cardiopulmonary bypass (CPB ) circuits with oxygenators have been developed. Proposed advantages o f heparin-coated CPB circuits include improved biocompatibility and th romboresistance. The purpose of this study was to evaluate our experie nce with heparin-coated CPB circuits in 20 patients. Heparin was given to maintain an activated clotting time equal to or greater than 200 s econds, while now rates were kept equal to or greater than 2 L/min. In dications for use of this circuit included recent stroke, posttraumati c injuries, recent gastrointestinal bleeding, protamine allergies, com bined cardiac and noncardiac procedures, and ventricular assist. Mean heparin dosage was 0.50 +/- 0.18 mg/kg and protamine dosage was 57.14 +/- 39.36 mg. Postoperative blood loss and transfusion requirements we re minimal. Postoperative complement levels of C3a and C5a were normal , suggesting excellent biocompatibility. There were no deaths or perio perative complications. Heparin-coated CPB circuits using a pump oxyge nator can be used safely with low-dose heparin administration in selec t patients requiring CPB.