Effects of unfractionated heparins on activated clotting time in patients undergoing coronary revascularization.

Abstract

Introduction: During coronary bypass graft surgery we observed a different behavior with respect to activated coagulation times in patients undergoing cardiopulmonary bypass, showing decreased values and greater needs of heparin redose. The administration of unfractionated heparin is necessary to achieve an optimal value that must be greater than 480 seconds in order to start cardiopulmonary bypass and proceed with coronary bypass graft surgery.
Objective: To determine the different effects of unfractionated heparins on activated coagulation times in patients who underwent coronary bypass graft surgery.
Methods: A retrospective descriptive study was carried out with a quantitative approach from the databases of the Department of Adult Cardiac Surgery of the Diagnostic Center of Advanced Medicine and Telemedicine where 90 adult patients were randomly selected, and were divided into 3 groups assigning 30 patients. In each group, one of the three brands of sodium unfractionated heparins [Cristalia (Sao Paulo, Brasil); Leo (Pharma, Barcelona, España) y Sanderson (Santiago de Chile, Chile)], was considered, only one brand of heparin was used during the entire surgery in each case of each group and was analyzed with the activated coagulation times. The heparin sensitivity index and comorbidities were also analyzed: insulin and non-insulin dependent Diabetes Mellitus and its relationship with the activated coagulation times.
Results: Leo heparin shows better effects compared to the other unfractionated heparins Sanderson and Cristalia, it reached optimal activated coagulation times, greater than 480 seconds, and required fewer repetitions of heparin doses.
Conclusion: The effects of unfractionated heparins on activated coagulation times in coronary bypass graft surgery may vary according to brand name and comorbidities such as insulin treated diabetes mellitus. Showing better effects with unfractionated heparins in relation to activated coagulation times compared to patients with diabetes mellitus without insulin treatment.