Control of heparin anticoagulation during cardiopulmonary bypass experience with a small initial dose

ABSTRACT

Forty adult patients of both sex undergoing cardiac surgical procedures requiring cardiopulmonary bypass were included in the present study. Patients were classified into two equal groups [each of 20 patients], group I were given the usual initial dose of heparin 400 IU/Kg while group II were given an initial dose of heparin 200 IU/Kg. Additional doses of heparin 50 IU/Kg added to attain ACT just above 400 sec in both groups to study this small initial dose for safe anticoagulation during CPB. It is found that the total heaparin dose before cannulation, the mean ACT values, the total heparin during surgery and the protamine dose for reversal were significantly lower in group II than in group I. So, starting with an initial heparin dose of 200 IU/Kg, adding small incremental doses to attain ACT just above 400 sec and proper ACT monitoring is a safe technique for heparin anticoagulation during CPB avoiding heparin overdosager