1975
DOI: 10.1016/s0022-5223(19)41499-2
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Heparin therapy during extracorporeal circulation

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Cited by 277 publications
(40 citation statements)
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“…Even though the ACT has been in use since the late sixties/early seventies, it still remains the gold standard to measure the effect of heparin during CPB. [3][4][5][6] This strategy, to monitor the heparin dosage for each patient based on the ACT, has proven to be superior over fixed heparin dosage schemes on postoperative blood loss. 7 ACT values greater than 400 or 480 seconds are generally maintained during CPB.…”
Section: Introductionmentioning
confidence: 99%
“…Even though the ACT has been in use since the late sixties/early seventies, it still remains the gold standard to measure the effect of heparin during CPB. [3][4][5][6] This strategy, to monitor the heparin dosage for each patient based on the ACT, has proven to be superior over fixed heparin dosage schemes on postoperative blood loss. 7 ACT values greater than 400 or 480 seconds are generally maintained during CPB.…”
Section: Introductionmentioning
confidence: 99%
“…Heparin resistance has been defined as the use of more than 35,000 UI/day of heparin. The ACT target value is controversial; however, general recommendations establish > 400 seconds as a safe parameter (7)(8)(9)(10)(11)(12)(13). It is important to recognize factors that may alter the ACT indirectly or directly.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, although the noncardiogrnic pulmonary cdema after cardiopulmonary bypass can be catastrophic, its incidence is low (31, 32) Ne\w-theless, we would speculate that thc observed "injurious" effect5 of protamine on the endothelium could play a role in thc clinical setting in some situations, situations in which the blood concentration of free protamine could uninientionally increase, e.g. in the case of administration of an inadequate large amount of protamine, rapid injection of protamine, or administration of protamine to paticnts with high sensitivity to heparin (marked bariations in the sensitivity to heparin and the rate of its clearance are known (37)). Also considering the inability of heparin to reverse the injurious effects of protamine on the endothelium, we would like to recommend that the minimum possible amount of protamine should be administered slowly to prevent any unneccessary increasc in plasma concentration of free protamine during heparin rcversal.…”
Section: Discussionmentioning
confidence: 99%