SCVA March 2016 Podcast: Cardiopulmonary Bypass Without Heparin
04/12/16 • 22 min
Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.
To view the article, click here.
Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.
To view the article, click here.
Previous Episode
SCVA June 2015 Podcast: Routine Postoperative Care of Patients Undergoing Coronary Artery Bypass Grafting on Cardiopulmonary Bypass
The postoperative course of a patient undergoing cardiac surgery (CS) is dictated by a largely predictable set of interactions between disease-specific and therapeutic factors. ICU personnel need to quickly develop a detailed understanding of the patient’s current status and how critical care resources can be used to promote further recovery and eventual independence from external support. The goal of this article is to describe a typical operative and postoperative course, with emphasis on the latter, and the diagnostic and therapeutic options necessary for the proper care of these patients. This paper will focus on coronary artery bypass grafting as a model for understanding the course of CS patients; however, many of the principles discussed are applicable to most cardiac surgery patients.
To view the article, click here.
Next Episode
SCVA March 2017 Podcast: Transplant Anesthesia: Where We've Been, Where We're Going
Nathaen Weitzel, one of the Editors-in-Chief of SCVA, talks to Ernesto Pretto of The Society for the Advancement of Transplant Anesthesia (SATA). They discuss transplant anesthesia and highlight how Seminars in Cardiothoracic and Vascular Anesthesia will now serve as the official home journal for SATA.
To view the SATA Editorial in the March 2017 issue of SCVA, click here.
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