Abstract
We analyzed the effects of a heparin-coated cardiopulmonary bypass (CPB) circuit on coagulation-fibrinolysis system and platelet, especially platelet surface glycopro-teins, in 18 adult patients. The patients were divided into two groups according to the circuit used; group D (n=10, Duraflo II heparin-coated) and group N (n=8, non-coated). Age, gender, operative procedures, aortic cross-clamping time and CPB time were not significantly different between groups. Heparin dosage was 3mg/kg and pericardial blood was recirculated in both groups. Blood samples were obtained before and after heparin administration, five and 30 minutes after CPB initiation, just before CPB termination and after protamine administration. During CPB, platelet count and fibrinogen concentration decreased with time in the group N, while they remained unchanged in the group D. Consequently, there were significant differences between two groups before CPB termination. Platelet surface glycoprotein IIbIIIa increased after CPB initiation, and TAT, PIC and D-dimer increased with time during CPB. There was no difference between groups. A heparin-coated circuit preserves platelet count and fibrinogen during CPB. Suppression of the activated platelet-surface interaction in the low-shear environment is likely to explain this effect.
