Low-dose versus high-dose heparinization during arteriovenous carbon dioxide removal

Murphy, J.; Savage, C.; Alpard, S.; Deyo, D.; Jayroe, J.; Zwischenberger, J.
November 2001
Perfusion;Nov2001, Vol. 16 Issue 6, p460
Academic Journal
The purpose of this study was to compare low-dose (LD) and high-dose (HD) systemic heparinization in a prospective randomized study of arteriovenous carbon dioxide removal (AVCO[sub 2]R) during acute respiratory distress syndrome, using a commercially available heparin-coated oxygenator. Adult sheep (n5 13) received an LD[sub 50] smoke inhalation and 40% TBSA third degree cutaneous flame burn injury. At 40--48 h post-injury, animals underwent cannulation of the carotid artery and jugular vein and were then randomized to HD heparin (activated clotting time, ACT > 300 s, n = 56) and LD heparin (ACT > 200 s, n = 57) and placed on AVCO[sub 2]R for approximately 72 h using an oxygenator with the Trillium Bio-Passive Surface™. Mean ACTs were significantly different, as expected (HD: 446 ± 26 s, LD: 213 ± 12 s, p < 0.05). AVCO[sub 2]R shunt flow averaged approximately 13% of cardiac output with mean CO[sub 2] removal similar in HD and LD, p = NS. The hematocrit, platelet count, and fibrin degradation products for the two groups were not different. No differences in thrombosis or bleeding were noted. In conclusion, LD systemic heparin (ACT, 200s) with a heparin-coated oxygenator does not increase thrombogenicity during AVCO[sub 2]R for smoke/burn-induced severe lung injury in sheep.


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