scholarly journals PREOPERATIVE ADMINISTRATION OF RECOMBINANT HUMAN ERYTHROPOIETIN TO THE PATIENTS UNDERGOING OPEN HEART SURGERY

1994 ◽  
Vol 55 (2) ◽  
pp. 283-289
Author(s):  
Setsuro IMAWAKI ◽  
Hajime MAETA ◽  
Yasushi SHIRAISHI ◽  
Ichiro ARIOKA ◽  
Yuka TSURUNO ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Human Erythropoietin ◽  
Preoperative Administration

scholarly journals Avoidance of Allogeneic Blood Transfusions by Treatment With Epoetin Beta (Recombinant Human Erythropoietin) in Patients Undergoing Open-Heart Surgery

Blood ◽  
1997 ◽  
Vol 89 (2) ◽  
pp. 411-418 ◽  
Author(s):  
Olaf Sowade ◽  
Harry Warnke ◽  
Paul Scigalla ◽  
Birgit Sowade ◽  
Werner Franke ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Heart Surgery ◽  
Cell Mass ◽  
Open Heart Surgery ◽  
Allogeneic Blood ◽  
Blood Transfusions ◽  
Open Heart ◽  
Epoetin Beta ◽  
Human Erythropoietin ◽  
The Mean

Abstract In a double-blind, randomized, placebo-controlled trial, we evaluated the ability of epoetin beta (recombinant human erythropoietin) to avoid allogeneic blood transfusions (ABT) and the associated risks in patients undergoing primary elective open-heart surgery and in whom autologous blood donation (ABD) was contraindicated. Seventy-six patients overall were enrolled onto the trial and were randomly assigned to the two treatment groups, 5 × 500 U/kg body weight (BW) epoetin beta or placebo intravenously over 14 days preoperatively. All patients received 300 mg Fe2+ orally per day during the treatment period. Preoperatively, the mean hemoglobin increase was 1.50 g/dL greater in epoetin beta patients than in placebo patients (95% confidence interval, 1.10 to 1.90 g/dL), allowing a rapid return to the baseline value by the seventh postoperative day in most epoetin beta patients. The mean volume of blood collected by intraoperative isovolemic hemodilution was 562 mL (red blood cell mass, 274 mL) in the epoetin beta group and 218 mL (red blood cell mass, 94 mL) in the placebo group, respectively. Only four patients (11%) in the epoetin beta group received an ABT, compared with 19 (53%) in the placebo group (P = .0003). Epoetin beta was most useful in patients with a perioperative blood loss greater than 750 mL, in those with a baseline hematocrit value less than 0.42, and in those aged ≥60 years. The iron supplementation proved adequate despite the fact that a significant decrease in ferritin (median, 48.1%) and transferrin saturation (median, 40.5%) was observed in epoetin beta patients preoperatively. No influence of epoetin beta therapy on blood pressure, laboratory safety variables, or the frequency of specific adverse events was observed. Intravenous epoetin beta treatment of 5 × 500 U/kg BW in combination with 300 mg Fe2+ orally per day administered over 14 days preoperatively is an adequate therapy for increasing mean hemoglobin levels by approximately 1.50 g/dL and reducing the allogeneic blood requirement in patients undergoing elective open-heart surgery and in whom ABD is contraindicated.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

Blood Coagulation Studies and Extracorporeal Circulation in Man

1967 ◽  
Vol 18 (03/04) ◽  
pp. 634-646 ◽  
Author(s):  
N Thurnherr
Keyword(s):  
Blood Coagulation ◽  
Extracorporeal Circulation ◽  
Blood Clotting ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Fibrinolytic System ◽  
Open Heart ◽  
Clotting Factors ◽  
Blood Clotting Factors

SummaryBlood clotting investigations have been executed in 25 patients who have undergone open heart surgery with extracorporeal circulation. A description of alterations in the activity of blood clotting factors, the fibrinolytic system, prothrombin consumption and platelets during several phases of the operation is given.

Open heart surgery in patients with cold agglutinins: Is the fear justified?

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
N Madershahian ◽  
T Wittwer ◽  
J Strauch ◽  
J Wippermann ◽  
UFW Franke ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cold Agglutinins
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