Padronização da dose de heparina sódica utilizada na cirurgia de revascularização do miocárdio sem circulação extracorpórea

Abstract

RBCCV 44205-759Padronização da dose de heparina sódica utilizada na cirurgia de revascularização do miocárdio sem circulação extracorpórea Standardization of the sodium heparin dose used in off-pump myocardial revascularization surgery Abstract Objective: To evaluate a methodology of anticoagulation during off-pump coronary artery bypass surgery (CABS) that promotes safe anticoagulation during the procedure (Activated Coagulation Time (ACT) ≥ ≥ ≥ ≥ ≥ 200 seconds), using an initial dose of 1 mg of sodium heparin/kg weight.Method: 40 patients (30 men and 10 women), with ages ranging from 41 to 85 years, were submitted to off-pump CABS, using an initial sodium heparin dose of 1mg/kg of weight. Ten minutes after the drug was administered, if the ACT was = 200 seconds, we initiated the revascularization procedure. If not, we administered an additional dose of 0.5mg/ kg heparin. During the surgery, the ACT was measured at 30 minute intervals. After revascularization, heparin reversal was achieved with a dose of protamine chloride equal do the total heparin dose infused during the procedure (1:1). Conclusões: Os resultados apresentados demonstram a segurança e eficácia da anticoagulação monitorizada pelo TCA nos pacientes submetidos à RM sem CEC, utilizando doses de 1mg heparina sódica/kg de peso, capaz de manter-se efetiva durante todo o procedimento cirúrgico, independentemente de variáveis como sexo ou idade. Results:Descritores: Revascularização miocárdica. Heparina. Tempo de coagulação do sangue total.