Korean J Anesthesiol.  1997 May;32(5):839-844. 10.4097/kjae.1997.32.5.839.

Cardiac Pump Failure due to Inappropriate Heparinization: A case report

• Park HP
• Kang H
• Lim SW

• KMID: 2240251
• DOI: http://doi.org/10.4097/kjae.1997.32.5.839

Abstract

Resistance to heparin therapy during cadiopulmonary bypass(CPB) is infrequent but can result in potentially life-threatening event. The precise etiology of the heparin resistance remains unknown. Clearly, the most predictive risk factor is a history of previous heparin exposure. Assessment of the clinical heparin effect, by determination of the activated clotting time(ACT), identifies those patients with heparin resistance. The potential risk of suboptimal anticoagulation is circumvented by the administration of additional heparin. High dose aprotinin suppress the activation of intrinsic coagulation pathway through surface activators inhibition, as documented by increases in the ACTs during CPB. Such effect of aprotinin on ACT, which can allow heparin-resistant patients to overestimate heparinization. We report a case of pump failure due to inappropriate heparinization in heparin-resistant patient.

Keyword

Blood; aprotinin; heparin; Heart; cardiopulmonary bypass

MeSH Terms

Aprotinin
Cardiopulmonary Bypass
Heart
Heparin*
Humans
Risk Factors
Aprotinin
Heparin