PMID- 20817849
OWN - NLM
STAT- MEDLINE
DCOM- 20110208
LR  - 20210206
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 116
IP  - 25
DP  - 2010 Dec 16
TI  - Antithrombin-heparin covalent complex reduces microemboli during cardiopulmonary 
      bypass in a pig model.
PG  - 5716-23
LID - 10.1182/blood-2010-05-284448 [doi]
AB  - Transcranial Doppler-detected high-intensity transient signals (HITS) during 
      cardiopulmonary bypass (CPB) surgery have been associated with postoperative 
      neurocognitive dysfunction, suggesting microemboli in the brain could be a 
      contributing factor. HITS occur despite administration of unfractionated heparin 
      (UFH). This study was done to determine whether antithrombin-heparin covalent 
      complex (ATH), a more potent anticoagulant than heparin, can reduce HITS during 
      CPB. In a pig CPB model, ATH, UFH, or UFH + antithrombin (AT) was intravenously 
      administered to female Yorkshire pigs after sternotomy. Twenty minutes later, 
      hypothermic CPB was initiated and continued for 1.25 hours, then normothermia was 
      re-established for 45 minutes. Protamine sulfate was given to neutralize the 
      anticoagulants, and pigs were allowed to recover. HITS were monitored using an 
      arterial flow probe placed over the carotid artery. Compared with UFH (300 or 
      1000 U/kg), ATH reduced the number of HITS during CPB in a dose-dependent manner. 
      AT (3 mg/kg) + UFH (300 U/kg) resulted in an intermediate HITS rate between UFH 
      and ATH (2 mg/kg in terms of AT). Examination of brain sections for emboli 
      formation confirmed that, similar to HITS, number of thrombi decreased in direct 
      proportion to ATH dosage. These results support the hypotheses that the majority 
      of HITS represent thromboemboli and that ATH reduces emboli formation during CPB.
FAU - Klement, Petr
AU  - Klement P
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Berry, Leslie R
AU  - Berry LR
FAU - Liao, Peng
AU  - Liao P
FAU - Wood, Henry
AU  - Wood H
FAU - Tressel, Paul
AU  - Tressel P
FAU - Smith, Lesley J
AU  - Smith LJ
FAU - Haque, Nihal
AU  - Haque N
FAU - Weitz, Jeffery I
AU  - Weitz JI
FAU - Hirsh, Jack
AU  - Hirsh J
FAU - Paredes, Nethnapha
AU  - Paredes N
FAU - Chan, Anthony K C
AU  - Chan AK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100903
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Animals
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombins/*therapeutic use
MH  - Blood Coagulation/drug effects
MH  - Brain/drug effects/pathology
MH  - Cardiopulmonary Bypass/*adverse effects
MH  - Embolism, Air/diagnosis/*prevention & control
MH  - Female
MH  - Heparin/*therapeutic use
MH  - Sus scrofa
MH  - *Ultrasonography, Doppler, Transcranial
EDAT- 2010/09/08 06:00
MHDA- 2011/02/09 06:00
CRDT- 2010/09/07 06:00
PHST- 2010/09/07 06:00 [entrez]
PHST- 2010/09/08 06:00 [pubmed]
PHST- 2011/02/09 06:00 [medline]
AID - S0006-4971(20)60368-8 [pii]
AID - 10.1182/blood-2010-05-284448 [doi]
PST - ppublish
SO  - Blood. 2010 Dec 16;116(25):5716-23. doi: 10.1182/blood-2010-05-284448. Epub 2010 
      Sep 3.