Simultaneous Use of Argatroban and Heparin during Cardiopulmonary Bypass

• Published in: Asian cardiovascular & thoracic annals 2010-02, Vol.18 (1), p.22-26
• Main Authors: Okamura, Toru, Shin'oka, Toshiharu, Ishibashi, Nobuyuki, Ishii, Hikaru, Kurosawa, Hiromi
• Format: Article
• Language: English
• Subjects: Animals; Anticoagulants - administration & dosage; Anticoagulants - blood; Antithrombin III - drug effects; Blood Coagulation - drug effects; Blood Platelets - drug effects; Cardiopulmonary Bypass - methods; Dogs; Drug Administration Schedule; Drug Therapy, Combination - methods; Fibrinogen - drug effects; Hemoglobins - drug effects; Heparin - administration & dosage; Heparin - blood; Infusions, Intravenous; Intraoperative Care - methods; Pipecolic Acids - administration & dosage; Pipecolic Acids - blood; Thrombin - drug effects
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/0218492309352034

Heparin is the routine anticoagulant for cardiopulmonary bypass, but complications due to heparin are often reported. This study assessed argatroban as an alternative to heparin. Normothermic cardiopulmonary bypass with hemodilution was performed for 2h in 15 dogs (mean weight, 9.8 kg) randomly assigned to 3 groups of 5 each. The controls were given heparin 200 IU·kg−1 before cardiopulmonary bypass; group A had argatroban infused continuously at a rate of 20 μg·kg−1 ·min−1; group H/A had half doses of both heparin (100 IU·kg−1) and argatroban (10 μg·kg−1·min−1). Blood samples were collected at 5 time points during the experiment. Activated clotting time, hemoglobin level, platelet counts, and serum concentrations of fibrinogen, antithrombin III, and thrombin-antithrombin III complex were measured. The platelet count was reduced significantly, and the production of thrombin-antithrombin III complex was inhibited in group H/A. Activated clotting time remained