Anticoagulation for Extracorporeal System
Blood, in the intact organism, is kept in a fluid state by the maintainance of an adequate blood flow, and rapid hepatic clearance of the coagulation factors following activation and fibrinolysis. There are also circulating serine protease inhibitors, such as antithrombin III (AT III), that prevent the spontaneous activation of certain factors in the coagulation cascade. During extracorporeal circulation, such as hemodialysis or cardiopulmonary bypass, the intrinsic pathway of the coagulation cascade is activated by the contact of the blood with a “foreign surface”. Once the cascade has been activated, it is necessary to use some form of anticoagulation to prevent clotting in the extracorporeal circuit.
KeywordsCoagulation Cascade Contact Activation Extracorporeal Circulation Extracorporeal Circuit Systemic Anticoagulation
Unable to display preview. Download preview PDF.
- 1.Nichols WL, Gerrard JM, Didisheim P (1981) Platelet structure, biochemistry and physiology. In: Poller L (ed) Recent Advances in Blood Coagulation 3-Churchill Livingstone, Edinburgh London Melbourne New York, pp 1-39.Google Scholar
- 2.Ansell J, Slepchuk N Jr, Kumar R, Lopez A, Southard L, Deykin D (1980) Heparin induced thrombocytopenia: a prospective study. Thromb Haemostas 43:61–65.Google Scholar
- 3.Rao AK, Holt JC, Pranee J, Niewiarowki S (1981) Release of platelet factor 4 in vivo after heparin injection. Thromb Haemostas 46:204 (Abstract).Google Scholar
- 10.De Moerloose P, Schweizer A, Reber G, Sinclair M, Bouvier CA, Gardaz JP (1987) Comparison between a low molecular weight and standard heparin for anticoagulation during extracorporeal CO2 removal in the dog. Thromb Res (in press).Google Scholar
- 11.Editorial (1968) A new approach to anticoagulant therapy. Lancet 1:513.Google Scholar
- 12.Bell WR (1982) Defibrinogenating enzymes. In: Colman RW (ed) Hemostasis and Thrombosis. Lippincott, Philadelphia, pp 1013–1027.Google Scholar
- 13.Latello ZS (1983) Retrospective study on complications and adverse effects of treatment with thrombin-like enzymes. A multicentre trial. Thromb Haemostas 50:604–609.Google Scholar
- 15.Oedekoven B, Bey R, Mottaghy K, Schmid-Schonbein H (1984) Gabexate Mesilate (FOY) as an anticoagulant in extracorporeal circulation in dogs and sheep. Thromb Haemostas 52:329–332.Google Scholar
- 17.Turney JH, Williams LC, Fewell MR, Parsons V, Weston MJ (1980) Platelet protection and heparin sparing with prostacyclin during regular dialysis therapy. Lancet 11:224–226.Google Scholar
- 19.Larm O, Larsson R, Olsson P (1983) A new non-thrombogenic surface prepared by selective covalent binding of heparin via a modified reducing terminal residue. Biomat Med Dev Art Org 11:161–173.Google Scholar
- 20.Inacio J, Bindslev L, Nilsson E, Gouda I, Olsson P (1986) Extracorporeal elimination of carbon dioxide using a surface heparinized vein-to-vein bypass system. Life Support Syst 4 Suppl 1:84–92.Google Scholar