ISOSORBIDE DINITRATE DOES NOT INTERFERE WITH HEPARIN ANTICOAGULATION - A PLACEBO-CONTROLLED COMPARISON WITH NITROGLYCERIN IN PATIENTS SCHEDULED FOR CORONARY-ARTERY SURGERY
O. Muikku, ISOSORBIDE DINITRATE DOES NOT INTERFERE WITH HEPARIN ANTICOAGULATION - A PLACEBO-CONTROLLED COMPARISON WITH NITROGLYCERIN IN PATIENTS SCHEDULED FOR CORONARY-ARTERY SURGERY, Acta anaesthesiologica Scandinavica, 38(6), 1994, pp. 583-586
The possible nitrate-induced heparin resistance was studied intraopera
tively in 40 patients undergoing coronary artery bypass grafting. The
patients were randomized to receive a continuous infusion of placebo,
nitroglycerin (0.5 mu g kg(-1) min(-1)) or isosorbide dinitrate (0.5 o
r 2.5 mu g kg(-1) min(-1)). After the infusion had been administered,
prior to the institution of cardiopulmonary bypass, for al least 60 mi
n, porcine intestine heparin 300 I.U. kg(-1) (as divided in two consec
utive doses of 100 and 200 I.U. kg(-1), respectively) was administered
to achieve systemic anticoagulation. Activated coagulation time value
s and plasma heparin anti-X(i), activity showed no significant differe
nces between the groups before and after tile administration of hepari
n. It is concluded that in doses given in the present study, organic n
itrates do not interfere with the anticoagulation effect of large dose
s of heparin required for the conduction of cardiopulmonary bypass.