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Inhibition and restoration of hemostasis in the young cardiac surgical patient

Published online by Cambridge University Press:  19 August 2008

David R. Jobes ,
Susan C. Nicolson  and
James M. Steven
David R. Jobes*
Affiliation:
From the Department of Anesthesiology, The Children's Hospital of Philadeiphia and The University of Pennsylvania School of Medicine, Philadelphia
Susan C. Nicolson
Affiliation:
From the Department of Anesthesiology, The Children's Hospital of Philadeiphia and The University of Pennsylvania School of Medicine, Philadelphia
James M. Steven
Affiliation:
From the Department of Anesthesiology, The Children's Hospital of Philadeiphia and The University of Pennsylvania School of Medicine, Philadelphia
*
Dr. David R. Jobes, Department of Anesthesiology, The Children's Hospital of Philadelphia, One Children's Center, Philadelphia, Pennsylvania 19104-4399, USA. Tel. 215-662-3778; Fax. 215-349-5341.
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Extract

For forty years, heparin has been used to temporarily inhibit normal coagulation so as to permit the use of extracorporeal circulation. It has proved effective in preventing gross thrombosis and has not been compromised by changes in adjunctive practices (such as profound hypothermia; circulatory arrest), new pharmacological therapies (such as anesthetics or antibiotics), devices (such as membrane oxygenators), or during use in patients at the extremes of age. Unfortunately, heparin has been and continues to be inefficient in preserving hemostatic function during cardiopulmonary bypass resulting in undesirable bleeding after surgery.

Keywords

Cardiac surgerycongenital, neonatalhemostasisextracorporeal circulationheparinprotamine
Type
World Forum for Pediatric Cardiology Symposium on Cardiopulmonary Bypass (Part 2)
Information
Cardiology in the Young , Volume 3 , Issue 4 , October 1993 , pp. 370 - 377
Copyright
Copyright © Cambridge University Press 1993

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