Safety of heparin-coated circuits in primates during deep hypothermic cardiopulmonary bypass

J. J. Sistino, Robert E. Michler, L. B. Mongero, A. Schwartz, C. Marboe, R. Geiman, P. Kwiatkowski

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The purpose of this study is to evaluate the biologic impact of heparin- coated circuits without systemic heparinization during deep hypothermia. Baboons (n=6) were placed on a heparin-coated pediatric closed-circuit cardiopulmonary bypass (CPB) system and cooled to 18°C. A control group (n=7) underwent similar protocol with a non heparin-coated circuit and received systemic heparin. Either low flow at 0.5 L/min/m2 (n=8; 4 in each group) or circulatory arrest (n=5; 2 in experimental group and 3 in control group) was used during deep hypothermia. Samples for complete blood count (CBC), hepatic and renal function tests, activated clotting time (ACT) and thrombelastogram (TEG) were obtained before, during, and after bypass. Cerebral blood flow was measured using Xenon-133 and autopsies were performed to assess end-organ damage. The ACT returned to baseline in both groups, and renal and hepatic function were within normal limits. There was no significant difference between the TEG values between the groups post bypass. Fibrin split products were absent and fibrinogen levels were normal in both groups following bypass. Cerebral blood flows were equivalent in both groups before and after bypass, although in the heparin-coated group cerebral blood flows were significantly higher during CPB. There were no brain histologic changes in the heparin-coated group and one focal cortical infarct in the control group. This study suggests that hypothermia induced a state of anticoagulation that did not result in thrombus formation or end organ dysfunction during CPB with a heparin-coated circuit. Safe use of these circuits without any systemic anticoagulation should be limited to conditions where the patient's coagulation time is prolonged such as hypothermia.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalJournal of Extra-Corporeal Technology
Volume25
Issue number1
StatePublished - 1993
Externally publishedYes

Fingerprint

Cardiopulmonary Bypass
Primates
Heparin
Cerebrovascular Circulation
Safety
Hypothermia
Control Groups
Kidney
Induced Hypothermia
Xenon
Blood Cell Count
Papio
Liver
Fibrin
Fibrinogen
Autopsy
Thrombosis
Pediatrics
Brain

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Sistino, J. J., Michler, R. E., Mongero, L. B., Schwartz, A., Marboe, C., Geiman, R., & Kwiatkowski, P. (1993). Safety of heparin-coated circuits in primates during deep hypothermic cardiopulmonary bypass. Journal of Extra-Corporeal Technology, 25(1), 15-21.

Safety of heparin-coated circuits in primates during deep hypothermic cardiopulmonary bypass. / Sistino, J. J.; Michler, Robert E.; Mongero, L. B.; Schwartz, A.; Marboe, C.; Geiman, R.; Kwiatkowski, P.

In: Journal of Extra-Corporeal Technology, Vol. 25, No. 1, 1993, p. 15-21.

Research output: Contribution to journalArticle

Sistino, JJ, Michler, RE, Mongero, LB, Schwartz, A, Marboe, C, Geiman, R & Kwiatkowski, P 1993, 'Safety of heparin-coated circuits in primates during deep hypothermic cardiopulmonary bypass', Journal of Extra-Corporeal Technology, vol. 25, no. 1, pp. 15-21.
Sistino, J. J. ; Michler, Robert E. ; Mongero, L. B. ; Schwartz, A. ; Marboe, C. ; Geiman, R. ; Kwiatkowski, P. / Safety of heparin-coated circuits in primates during deep hypothermic cardiopulmonary bypass. In: Journal of Extra-Corporeal Technology. 1993 ; Vol. 25, No. 1. pp. 15-21.
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