Blood Coagulation Problems during Extracorporeal Circulation in Man

Abstract

After extracorporeal circulation in man there is a constant decrease in platelet number of about 40-50% of the initial value at the end of the cardiac by-pass. The plasma fibrinogen level is also decreased at the of the by-pass, in some patients a further fall of this level is noted. The amount of heparin antidote required was based on an in vitro titration test. The protamine sulphate-heparin ratio was 1.5 and the polybrene-heparin ratio 1.4 for all cases where only one dose of antidote was given. A higher polybrene-heparin ratio (2/1) was experimented in dogs and no fall in platelet counts or fibrinogen level was observed. In contradistinction with protamine, disproportionatedly high polybrene-heparin ratio does not increase, within certain limits, the clotting time. No red cell agglutination or hypotension were noted, even after rapid intravenous administration of these high doses of polybrene.