Issue |
J Extra Corpor Technol
Volume 27, Number 2, June 1995
|
|
---|---|---|
Page(s) | 85 - 92 | |
DOI | https://doi.org/10.1051/ject/199527285 | |
Published online | 18 August 2023 |
Technique
Perfusion Techniques for Heparin-Bonded Circuits
1
Department of Surgery and Anesthesia, West Virginia University, Morgantown, West Virginia
2
Robert C. Byrd Health Sciences, West Virginia University, Morgantown, West Virginia
* Address correspondence to: Michael J. Hollingsed, PA-C, CCP, Department of Surgery, Robert C. Byrd Health Sciences, West Virginia University, Morgantown, VA 26506
Recent advances in cardiopulmonary bypass techniques include the development of durable, covalently bonded heparin coated surfaces using end-point attachment techniques. Advantages of heparin-coated cardiopulmonary bypass include reduced systemic heparin, avoidance of protamine sulfate at the completion of the procedure, enhanced biocompatibility of the circuit, successful application of cardiopulmonary bypass in cases where bleeding may become a problem, and in application of assist devices.
Our experience with this technology has led to the development of guidelines and management strategies. We generally consider application fortwo categories: 1) pharmacotoxicity, i.e., allergic reaction to heparin or protamine; and 2) progression of problems, such as prolonged bleeding tendencies (aspirin) or hemorrhage from cerebral vascular accident. Applications of this technology require tip to tip heparin-bonding, "streamlining" the circuit, meticulous attention to fluid mechanics, crystalloid cardioplegia, precise heparin management, and reversed Trendelenburg position for post-cardiopulmonary bypass volume.
Key words: circuits / cardiopulmonary bypass / biocompatible / heparin-bonded
© 1995 AMSECT
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