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LOW MOLECULAR WEIGHT HEPARIN, STANDARD HEPARIN AND ANCR0D AS ANTICOAGULANT FOR EXTRAC0RP0REAL MEMBRANE LUNG CO2 REMOVAL IN DOGS
Journal article

LOW MOLECULAR WEIGHT HEPARIN, STANDARD HEPARIN AND ANCR0D AS ANTICOAGULANT FOR EXTRAC0RP0REAL MEMBRANE LUNG CO2 REMOVAL IN DOGS

  • Reber, G Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
  • de Moerloose, Ph Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
  • Sinclair, M Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
  • Schweizer, A Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
  • Gardaz, J P Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
  • Bouvier, C A Haemostasis Unit and Anaesthesiology Dpt, Geneva University Hospital, Geneva, Switzerland
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  • 2018-8-23
Published in:
  • XIth International Congress on Thrombosis and Haemostasis. - Schattauer GmbH. - 1987
English A low molecular weight heparin (LMWH, Sandoz), a standard heparin (SH, LiqueminR) and ancrod (Arvin^)have been compared in an extracorporeal veno-venous bypass for CO2 removal using a membrane lung in dogs. Four animals received 150 anti-FXa U/kg in bolus followed 90 min later by 40 anti-FXa U/kg/h of LMWH and four other 300 IU/kg followed by 100 IU/kg/h of SH. Six dogs received 1 U/Kg of ancrod intravenously during 2 h before bypass started.Mean FXa inhibition was 49% in LMWH group and 29% in SH group, mean FI la inhibition 31% and 49% respectively. No statistically significant differences were found between LMWH and SH groups for any of the parameters measured (fibrinogen, FV, antithrombin III, plasminogen, α 2-anti piasmin, platelet counts). At the end of bypass 5000 U protamine abolished both anti-FXa and anti-FIIa activities in SH group, but failed to neutralize more than half of anti-FXa in LMWH group. In ancrod group no clottable fibrinogen was detectable. A dramatic fall of α2-antiplasmin was observed after ancrod infusion and, during bypass, sharp decreases in FV and platelet counts without significant antithrombin III and plasminogen consumption were noted.No bleeding occurred in any group throughout the seven hours of bypass. The main finding was fibrin deposition in the tubing in three out of four dogs receiving LMWH, whereas no fibrin deposition occurred either in SH or in ancrod group.These results suggest that in this model which involves blood contact with artificial surfaces (1) SH and ancrod are efficient to prevent clotting, but not the LMWH used at the dosage reported (2) high anti-FIIa activities are required to prevent fibrin formation (3) ancrod defibrination does not protect against severe haemostatic disturbances and (4) the use of LMWH may raise problems when emergency neutralisation procedures are required.
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  • English
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closed
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https://sonar.ch/global/documents/252456
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