Issue |
J Extra Corpor Technol
Volume 32, Number 4, December 2000
|
|
---|---|---|
Page(s) | 207 - 213 | |
DOI | https://doi.org/10.1051/ject/2000324207 | |
Published online | 14 August 2023 |
Original Article
Technique for Routine Use of Heparin Bonded Circuits with a Reduced Anticoagulation Protocol
Department of Cardiothoracic Surgery, Boston Medical Center and West Roxbury Veteran Affairs Medical Center, Boston University School of Medicine, Harvard Medical School, Boston, Massachusetts
* Address correspondence to: Paul J. O’Gara, BS, CCP Boston Medical Center 88 E. Newton St. Boston, MA 02118 Paul.Ogara@bmc.org
The use of heparin-bonded cardiopulmonary bypass circuits (HBCs) with reduced anticoagulation protocol during cardiac surgery attenuates some of the adverse pathophysiologic responses to cardiopulmonary bypass (CPB). The strategies of how to maximize improvements in clinical outcomes using this technique are still debated. This article describes in detail a comprehensive approach to strategies developed at Boston Medical Center and the West Roxbury Veteran Affairs Medical Center in over 4000 cases in which HBC with a reduced anticoagulation protocol is used routinely. Important elements of this technique include elimination of cardiotomy reservoir during coronary artery bypass graft surgery (CABG), autologous blood priming, normothermic CPB, and precise heparin and protamine titration. Adaptation and variation in this technique to specific clinical situations is also highlighted.
Key words: cardiopulmonary bypass / heparin bonded circuits / reduced anticoagulation protocol
© 2000 AMSECT
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