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  • Title: A comparison of low vs conventional-dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery.
    Author: Fromes Y, Daghildjian K, Caumartin L, Fischer M, Rouquette I, Deleuze P, Bical OM.
    Journal: Anaesthesia; 2011 Jun; 66(6):488-92. PubMed ID: 21501130.
    Abstract:
    The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high-dose anticoagulation with a low-dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred patients who received 300 IU.kg(-1) heparin were compared with 68 patients who received heparin according to an individually adjusted activated coagulation time target of 300 s, resulting in a mean (SD) heparin dose of 145 (30) IU.kg(-1) . There were no thromboembolic events in either group; however, patients in the low-dose group had lower 24-hour mean (SD) postoperative blood loss than the conventional group (545 (61) vs 680 (88) ml, p=0.001) and a reduced rate of transfusion of allogeneic blood (15% patients transfused vs 32%, p=0.01). An individually tailored low-dose heparin regimen for minimal cardiopulmonary bypass is safe and may be associated with reduced bleeding and lower transfusion requirements.
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