Coagulation patterns during deheparinization with immobilized polycation

Détails

ID Serval
serval:BIB_F8815912014A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Coagulation patterns during deheparinization with immobilized polycation
Périodique
ASAIO Journal
Auteur(s)
von Segesser  L. K., Mihailevic  T., Tonz  M., Leskosek  B., von Felten  A., Turina  M.
ISSN
1058-2916
Statut éditorial
Publié
Date de publication
09/1994
Peer-reviewed
Oui
Volume
40
Numéro
3
Pages
M565-9
Notes
Journal Article --- Old month value: Jul-Sep
Résumé
Reversal of systemic heparinization with protamine is problematic during perfusion with heparin surface coated devices because protamine reacts with both circulating and surface bound heparin. Hence, the development of a deheparinization device allowing for ex vivo heparin absorption by the means of an immobilized polycation is of prime interest for a number of indications. To assess the coagulation patterns during ex vivo deheparinization, a heparin surface coated venovenous pump loop including a plasma separator with immobilized polycation was studied in a bovine model (n = 6, body weight 71 +/- 5 kg). After systemic heparinization with 300 IU of heparin/kg body weight, spontaneous evolution (control) of coagulation parameters was compared to ex vivo deheparinization with a mean pump flow of 500 ml/min. No device failure occurred during the procedures and all plasma separators remained patent. These baseline levels were measured for control versus ex vivo deheparinization: activated coagulation time 158 +/- 6 sec (161 +/- 4 sec: NS), antithrombin III 101 +/- 5% (108 +/- 8%: NS), fibrinopeptide A 3.4 +/- 1.7 ng/ml (4 +/- 1.7 ng/ml: NS). After heparin application mean activated coagulation time was longer than 1000 sec in both groups. Sixty minutes later, the activated coagulation time was 757 +/- 43 sec (184 +/- 5 sec: P < 0.05), antithrombin III was 96 +/- 12% (99 +/- 2%: NS), and fibrinopeptide A was 2.7 +/- 0.7 ng/ml (9.5 +/- 3.5 ng/ml: P < 0.05). It is concluded that ex vivo deheparinization resulted in significant acceleration of activated coagulation time normalization. Fibrinopeptide A production in the group with ex vivo deheparinization appeared to be higher. As antithrombin III levels were close to normal in both groups, allowing for adequate function of circulating as well as surface bound heparin, and the coagulation process was blocked by significant heparin levels in the control group, the difference for FPA may be due to activation of the coagulation process in the surgical field (sternotomy).
Mots-clé
Animals Antithrombin III/metabolism *Blood Coagulation Cations Cattle Evaluation Studies as Topic Extracorporeal Circulation/*instrumentation/*methods Fibrinogen/metabolism Fibrinopeptide A/metabolism Heparin/blood/*isolation & purification Humans Polyamines Time Factors
Pubmed
Création de la notice
14/02/2008 15:17
Dernière modification de la notice
03/03/2018 22:52
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