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Biomedical subjects

M Ballesteros

Publications and source records attributed to M Ballesteros.

At least 37 records · Page 2Linked to original sources
PubMed1998

Final results of the Maryland WIC 5-A-Day Promotion Program.

OBJECTIVES: This National Cancer Institute-funded study sought to increase fruit and vegetable consumption among women served by the WIC program in Maryland. METHODS: Over a 2-year period, a multifaceted intervention program using a randomized crossover design sought to increase fruit and vegetable consumption at 16 WIC program sites in Baltimore City and 6 Maryland counties. Participants were surveyed at baseline, 2 months postintervention, and 1 year later. RESULTS: Two months postintervention, mean daily consumption had increased by 0.56 +/- 0.11 servings in intervention participants and 0.13 +/- 0.07 servings in control participants (P = .002). Intervention participants also showed greater changes in stages of change, knowledge, attitudes, and self-efficacy. Changes in consumption were closely related to number of nutrition sessions attended, baseline stage of change, race, and education. One year later, mean consumption had increased by an additional 0.27 servings in both intervention and control participants. CONCLUSIONS: Dietary changes to prevent cancer can be achieved and sustained in this hard-to-reach, low-income population. However, many obstacles must be overcome to achieve such changes.

Adolescent↗
PubMed1997

N300, P300 and the emotional processing of visual stimuli.

Two components of the ERPs elicited by emotional visual stimuli, N300 and P300, were investigated. The emotional charge is explained through two dimensions: arousal (relaxing (R) or activating (A)) and valence (attractive (+) or repulsive (-)). Stimuli were slides of nudes (A+), human remains (A-), landscapes (R), and buildings (neutral (N)). The peculiar structure of the stimuli, along with a distracting task which allowed us to disguise the real aim of the experiment, helped to avoid a sort of 'relevance-for-task effect', mainly related to cognitive processes, which could explain P300 reactions in response to emotional visual stimuli found in several experiments. The ERPs were recorded from 32 subjects at F3, Fz, F4, C3, Cz, C4, P3, Pz and P4. In contrast to previous studies, P300 did not show greater amplitudes in response to emotional stimuli than to N. N300 showed greater amplitudes in response to A+ at parietal sites, the greatest differences being those with respect to A-. No inter-hemispheric differences were found. N300 confirms its usefulness as a variable for studying emotional reactions to visual stimuli.

Adult↗
PubMed1997

Molecular cloning and expression of a human phosphodiesterase 4C.

A cDNA coding for a human phosphodiesterase 4C (PDE4C2) was isolated from the mRNA prepared from the glioblastoma cell line, U87. The cDNA contained an ORF of 1818 bp corresponding to a 605 amino acid polypeptide. The sequence differed at the 5' end from the human PDE4C previously reported (Engels, P. et al, 1995 FEBs Letters 358, 305-310) indicating that it represents a novel splice variant of the human PDE4C gene. Evidence was also obtained for a third 5' splice variant. The PDE4C2 cDNA was transfected into both COS 1 cells and yeast cells, and shown to direct the expression of an 80 kD polypeptide by Western blotting using a PDE4C specific antiserum. The activity of cell lysates was typical of PDE4 being specific for cAMP and inhibitable by the selective inhibitor, rolipram. However, the Km for cAMP of the enzyme produced in COS cells was 0.6 microM compared to 2.6 microM for the yeast 4C activity. In addition the COS cell PDE4 activity was much more sensitive to R rolipram than the yeast PDE4 enzyme (IC50 of 23 nM compared to 1648 nM). This difference in rolipram sensitivity was associated with the detection of a high affinity [3H] R rolipram binding site on the COS cell 4C enzyme but not on the yeast expressed enzyme. The results indicate that the enzyme can adopt more than one active conformation, which are distinguished by their interaction with rolipram.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1997

Nontraumatic lower extremity amputations in diabetic and non-diabetic subjects in Madrid, Spain.

The purpose of this study was to determine the incidence of non-traumatic lower extremity amputations (LEAs) in diabetic and non-diabetic subjects in Madrid, Spain, and their direct cost. All patients who underwent LEAs between the 1st of January 1994 and the 31st of December 1996, and who had lived in area 7 of the city (569,307 inhabitants) for at least the last 6 months, were identified through operating theatre records cross-checked with Vascular Surgery Department discharge records. In addition, the direct cost of LEAs per year was estimated, taking into account the length of the hospital stay, the period of rehabilitation in the outpatient clinic after discharge, and the use of artificial limbs and their maintenance. The incidence of LEAs was 1.6 (95% CI: 1.1-2.2) per 10(5) non-diabetic subjects and 46.1 (95% CI: 34.5-57.6) per 10(5) diabetic patients. Relative risk was 28. Total direct costs associated with LEAs per year were US$ 56,131 in the diabetic population and US$ 30,765 in the non-diabetic population. Thus, potential cost savings associated with excess amputations in the diabetic population was estimated at US$ 541,353 per year of US$ 94,736 per 10(5) inhabitants. It is concluded that the incidence of LEAs in both diabetic and non-diabetic populations in area 7 is the lowest reported in European countries. The potential cost savings per 10(5) inhabitants and per year is estimated at US$ 94,736.

Adult↗
PubMed1996

Soluble insulin-like growth factor-II/mannose 6-P receptor inhibits deoxyribonucleic acid synthesis in cultured rat hepatocytes.

Insulin-like growth factor-II/mannose 6-P (IGF- II/M6P) receptor is released from cultured cells and tissues in a soluble form that retains its affinity for IGF-II. To test the possibility that soluble receptor can therefore modulate the activity of IGF-II, we determined the effect of purified soluble receptor on DNA synthesis in cultured rat hepatocytes stimulated with epidermal growth factor (EGF) (5 ng/ml) and IGF-II (200 ng/ml). Thymidine incorporation in hepatocytes in the presence of EGF and IGF-II was inhibited by soluble receptor (50% inhibition at 212 +/- 45 ng/ml). However, thymidine incorporation in the presence of EGF alone was also inhibited with similar potency. This inhibitory effect was removed by immunodepletion of receptor from the purified preparation, demonstrating the absence of nonspecific cytotoxic effects of the preparation. Although soluble receptor blocked IGF-II binding to hepatocytes, inhibition of EGF-stimulated DNA synthesis was not due to inhibition of EGF binding or uptake by the cell. These results suggest that soluble IGF-II/M6P receptor not only plays a role in modulating the action of IGF-II but may also have IGF-independent actions on cells, possibly by modulating M6P protein action.

Animals↗
PubMed1995

[Optimization of ventricular function during anesthesia induction by administering crystalloids and colloids to heart surgery patients].

OBJECTIVE: To describe the changes in cardiac function after administration of three different solutions infused after anesthetic induction. PATIENTS AND METHODS: Thirty-six patients scheduled for elective aortocoronary bypass surgery were randomly distributed into three groups. Over a period of 25 min after anesthetic induction, 12 received 10 ml/kg of Ringer solution (low dose crystalloid group), 12 received 20 ml/kg of Ringer solution (high dose crystalloid group), and 12 received 10 ml/kg of Ringer solution with 10 ml/kg of hydroxi-ethyl-almidon solution 450,000 D, 0.7 substitution grade (group C-HEA). Minute volume, systemic and pulmonary pressures, osmolality of blood and urine, and plasma and urine sodium concentrations were measured before and after infusion of the assigned liquid. RESULTS: In spite of the volume infused, low dose crystalloid group showed a high incidence of oliguria, increased urinary osmolality and decreased sodium in urine. Cardiac and systolic indices and left ventricular work load remained stable after infusion of the assigned liquid in low and high dose crystalloid groups, whereas they increased significantly ion group C-HEA (+23%, +16% and +20%). CONCLUSION: Administration of restricted doses of crystalloids after anesthetic induction favors the retention of water and sodium. Higher doses of crystalloids weaken this effect. However, neither of these two regimens leads to a more effective cardiac work load. A combination of crystalloids and colloids administered immediately after anesthetic induction temporarily improves cardiac performance during surgery.

Aged↗
PubMed1995

[Effect of controlled hypotension using sodium nitroprusside on platelet aggregation].

OBJECTIVE: To determine the influence of sodium nitroprusside (SNP) on platelet aggregation when this agent is used to induce hypotension during surgery. PATIENTS AND METHODS: Spontaneous platelet aggregation (SPA) determined by impedance measurement and induced platelet aggregation (IPA) determined by turbidimetry were studied in 30 subjects scheduled for elective ear, nose or throat surgery. Fifteen patients in the SNP group (SNPG) received SNP in doses adjusted to maintain a mean arterial pressure of 50 mmHg. Another 15 patients who did not receive SNP served as controls. RESULTS: SPA increased progressively in both groups. The greatest increase occurred after anesthetic induction (control group +172%, SNPG +48%); the highest level recorded was reached on the morning of the first day after surgery (control group +215%, SNPG +46%). IPA decreased after anesthetic induction (control group -21%, SNPG -40%) and stayed down throughout surgery. IPA was higher on the first morning after surgery than before the operation (control group +35%, SNPG +2%). SPA was significantly higher 60 minutes after start of surgery than before surgery in the control group; IPA and SPA were likewise higher in these patients the morning after surgery. CONCLUSIONS: Platelet aggregation increases during surgery and in the immediate postoperative period. This increase is attenuated when SPA is given to induce hypotension. SPA should be determined by measurement of impedance in whole blood when the nature of platelet aggregation during surgery is being studied, given that early increases in IPA can be masked as a result of the low sensitivity of turbidimetry.

Blood Coagulation Disorders↗
PubMed1993

Optimization of the simultaneous saccharification and fermentation process using thermotolerant yeasts.

Different treatments to improve the thermotolerance of fermenting yeasts for simultaneous ethanol saccharification and fermentation process of cellulosic materials have been examined. Yeasts of the genera Saccharomyces and Kluyveromyces were tested for growth and fermentation at progressively higher temperatures in the range of 42-47 degrees C. The best results were obtained with K. marxianus LG, which was then submitted to different treatments in order to achieve thermotolerant clones. A total of 35 new clones were obtained that dramatically improved the SSF of 10% Solka-floc substrate at 45 degrees C when compared to the original strain, some with ethanol concentrations as high as 33 g/L.

Adaptation, Physiological↗
PubMed1993

[The characterization of a pattern of metabolic response and energy utilization in septic surgical patients].

OBJECTIVES: To describe the energy-metabolic response pattern in septic surgical patients. Carried out in the Surgical Intensive Care Unit (SICU). Hospital Universitario. PATIENTS: Eighteen surgery patients. Inclusion criterion: sepsis according to the criteria of the American Intensive Care Society (1992). PROCEDURES: Standard invasive and metabolic hemodynamic monitoring: sequential recording of direct measuring variables and calculation of derived variables. METHOD: Monitoring of the critical illness until final discharge due to improvement or death. We included 642 hemodynamic-metabolic evaluations, codified and incorporated into a data base specially designed for the purposes. Surviving and non-surviving groups (SG and NSG) were identified. Inter-group differences were analysed using the Student or MANOVA test, and intra-group analysis was done with the ANOVA test. Significant difference p less than 0.05. MAIN RESULTS: On admission to the SICU, oxygen consumption (VO2) and carbon dioxide production (VCO2) were lower in the SG (198 mL/min vs 233 Ml/Min) and (105 mL/min vs 172 mL/min), while RQ was significantly higher (1.08 vs 0.43): the NSG showed lower arterial bicarbonate (HCO3) (11.8 mOsm/Lt vs 14.4 mOsm/Lt). At the end of monitoring, there were significant inter-group differences for RQ (0.85 vs 1.02), VO2 (346 mL/min vs 398 mL/min), VCO2 (271 mL/min vs 359 mL/min) and arterial HCO3 (18.0 mOsm/l vs 15.6 mOsm/L) when the SG was compared with the NSG. With the passage of time, in the SG, VO2 dropped progressively, the arterial HCO3 rose, and RQ rose to lipogenesis level (days 6 and 7). In the NSG, there was a late period of RQ in excess of 1.0, severe metabolic acidosis, and persistently high VO2 and VCO2. Caloric requirements were significantly higher in the NSG (1.64 kcal/min, vs 1.9 cal/min-p < 0.001). CONCLUSIONS: There were major differences between the SG and NSG energy-metabolic pattern during surgical sepsis. Initially, the SG showed serious lesion parameters with RQ characteristic of a metabolism basically of the glucose oxidation type: the VO2 was high in the NSG, with persistent metabolic acidosis, and RQ initially explained by the accumulation of ketonic bodies and, subsequently, by lipogenesis. Definition of a metabolic pattern in the septic surgery patient establishes criteria of which are unquestionably useful in prognosis, suggesting that the therapeutic program be restructured at the moment when it is noted that the patient's pattern departs from that of the survivors.

Analysis of Variance↗
PubMed1993

[Cardiac protection in heart surgery interventions by preventive drug administration before extracorporeal circulation. Studies with troponin T as a parameter for perioperative myocardial damage].

The present study was designed to test if prophylactic intravenous nifedipine or nitroglycerine could reduce myocardial damage after cardiopulmonary bypass. 45 patients scheduled for elective coronary artery bypass grafting were divided at random into three groups: Group 1: control; group 2: nifedipine (0.25 microgram/kg/min); group 3: nitroglycerine (1.5 micrograms/kg/min). Infusion period reached from the beginning of anaesthesia until crossclamp of the aorta. Myocardial damage was estimated by troponin T (TnT), CK-MB and ST-segment analysis of the ECG. TnT is a cardiospecific protein from the contractile apparatus of striated muscle cells. TnT-levels might provide a very sensitive marker of small amounts of cardiac muscle necrosis. It was tested with an ELISA/one-step sandwich-assay with streptavidin-technology [9]. Criteria for ischemia in the ST-segment analysis were (according to Smith et al. [19]): ST-depression > 1 mm from baseline or ST-elevation > 2 mm from baseline at J-point + 60 ms. Statistical interpretation was done by one- and two-factorial analyses of variance (including multivariate analyses of variance). Correlation between two variables was tested by regression analysis. A level of p < 0.05 was taken for indicating statistical significance. Biometrical data, circulation data and data from cardiopulmonary bypass were without significant differences among all groups (Tables 1 and 2). Starting from normal values (< 0.05 ng/ml) TnT significantly rose in all groups immediately after cardiopulmonary bypass and remained elevated until the forth day after operation (values between 0.4 and 0.6 microgram/ml) (Figure 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

The role of enoximone in cardiac surgery.

After cardiopulmonary bypass (CPB), some patients may require circulatory support. This study examined the role of the phosphodiesterase-III inhibitor, enoximone, in cardiac surgery. Eighty patients selected by chance were allocated randomly to two groups: 40 patients received enoximone 1.0 mg kg-1 approximately 10 min before weaning from CPB and 40 served as a control group. Additional pharmacological therapy (adrenaline, noradrenaline, nitroglycerin) was given, when necessary, by anaesthetists who were not involved in the study. In addition to standard monitoring, skin capillary blood flow was assessed using a laser Doppler technique before, during and after CPB until 2 h after the end of the operation. In the period after bypass, cardiac index was always significantly greater in the enoximone than in the control group. Systemic and pulmonary vascular resistance were less in the enoximone-treated patients, indicating a reduction in right and left ventricular wall stress. Oxygen consumption in the enoximone patients was significantly greater after CPB, whereas intrapulmonary shunting was comparable in the two groups. In comparison with baseline values, skin capillary blood flow in the enoximone patients was always greater than that in the control group. In comparison with the control patients, significantly fewer enoximone patients needed adrenaline, and in a smaller dose, even 2 h after operation, whereas more enoximone patients required noradrenaline therapy for a short period. We conclude that the use of enoximone before weaning from CPB improved overall cardiac function, reduced the need of catecholaminergic inotropic support, and provided increased organ perfusion up to 2 h after operation.

Adult↗
PubMed1992

Endothelin plasma levels in old and young patients during open heart surgery: correlations to cardiopulmonary and endocrinology parameters.

We compared endothelin (ET) plasma levels during and after aortocoronary bypass (CPB) grafting in old and young patients. Correlations to cardiopulmonary parameters and catecholamines were tested. The study included 22 patients (11 aged greater than 70 years and 11 aged less than 55 years). Measurements were performed after induction of anesthesia (baseline), before bypass, during bypass, after patients were weaned off bypass, at the end of operation, and after 4-h intensive care (IC) treatment. ET [radioimmunoassay (RIA) technique] and catecholamines [high pressure liquid chromatography (HPLC) technique] plasma levels were determined from arterial blood samples; hemodynamics (pulmonary artery catheter), oxygen data, and laser Doppler flow were also monitored. Baseline ET plasma levels were within normal range (young, 3.1 +/- 0.9 pg/ml, old, 4.5 +/- 1.4 pg/ml). Old patients had higher values during the entire investigation period. During CPB ET plasma levels increased to a maximum immediately after patients were weaned off bypass. A significant increase (twofold to baseline) was noted during IC therapy. ET plasma levels did not correlate to catecholamine plasma levels or to hemodynamic or laser Doppler flow parameters. A significant correlation existed between ET plasma levels and oxygen consumption. Monitoring ET plasma levels appears to be of minor value in predicting circulatory changes and assessing surgical stress. Further investigations must elucidate the increase in oxygen consumption and its correlation to ET plasma level.

Aged↗
PubMed1992

Insulin-like growth factor-I (IGF-I) and transforming growth factor-beta 1 release IGF-binding protein-3 from human fibroblasts by different mechanisms.

Human neonatal fibroblasts in monolayer culture secrete insulin-like growth factor-binding proteins (IGFBPs), which may modulate IGF action. To examine whether an increase in extracellular concentrations of IGFBPs in response to IGF-I is due to the release of cell-associated IGFBPs, we measured secreted and cell-associated IGFBP-3 immunologically in fibroblast monolayers treated with IGF-I and IGF analogs with altered affinities for the IGF receptors and IGFBPs. IGFBP-3 in medium conditioned by fibroblasts treated with IGF-I was significantly increased (P < 0.05) compared with that in medium from untreated cultures; concomitantly, cell-associated IGFBP-3 was significantly decreased (P < 0.05). [Ser24]IGF-I (reduced affinity for IGF receptors) also increased secreted IGFBP-3 and decreased cell-associated IGFBP-3. In contrast, IGFBP-3 concentrations in medium conditioned by fibroblasts treated with B-chain IGF-I (reduced affinity for IGFBPs) were not significantly increased, and cell-associated IGFBP-3 was unchanged. Heparin, which releases proteins attached to cell surface proteoglycans, increased medium concentrations of IGFBP-3 and decreased IGFBP-3 binding to fibroblasts. An IGFBP of 29-31 kilodaltons (kDa) showed a pattern of regulation similar to that of IGFBP-3, while a third IGFBP, of 24 kDa, was decreased in IGF-I- and [Ser24]IGF-I-conditioned medium and unchanged by B-chain IGF-I and heparin. Preincubation with transforming growth factor-beta 1 (TGF beta 1), which stimulates fibroblast IGFBP-3 production, or human serum-derived IGFBP-3 did not increase cell-associated IGFBP-3. Analysis of total RNA isolated from fibroblasts revealed that IGFBP-3 mRNA was increased by TGF beta 1, but not by IGF-I. These data suggest that IGFs and TGF beta 1 release fibroblast IGFBPs by distinct mechanisms: IGFs by binding and subsequent release of cell-associated IGFBP-3 and 29- to 31-kDa IGFBP, and TGF beta 1 by increased de novo synthesis of IGFBP-3.

Carrier Proteins↗
PubMed1992

[Cardiorespiratory and microcirculatory effects following volume replacement using a new hydroxyethyl starch preparation].

Volume therapy is often necessary in cardiac surgery to maintain stable haemodynamics. Various different hydroxyethyl starch (HAES) solutions with different concentrations, mean molecular weights, and degrees of substitution are available for this purpose. In determining the ideal type of volume therapy, not only changes in macrohaemodynamics, but also the influence on microcirculatory blood flow have to be taken into account. The efficacy of a new 10% HAES 130/0.5 solution was studied in cardiac surgery patients in comparison to a standard 10% HAES 200/0.5 preparation. METHODS. In patients scheduled for elective aortocoronary bypass grafting who had a pulmonary capillary wedge pressure (PCWP) of less than 4 mm Hg after induction of anaesthesia, either a new 10% HAES 130/0.5 (n = 15) or a standard 10% HAES 200/0.5 solution (n = 15) was infused to double the reduced PCWP; 15 patients without volume therapy served as controls (n = 15). A two-channel laser Doppler skin blood-flux monitor was used to evaluate microcirculatory alterations. Measurements of laser Doppler flux (LDF) was simultaneously performed at the patient's forehead and forearm before and after volume infusion as well as during and after cardiopulmonary bypass (CPB). In addition, changes in gross haemodynamics were documented using a pulmonary artery catheter. Plasma viscosity and various laboratory parameters, including calculation of intrapulmonary right-to-left shunting (Qs/Qt), were also measured. RESULTS. Cardiac index (CI) increased in both volume groups (HAES 130: max. +38%; HAES 200: +55%). The increases in PCWP and CI were maintained at 40 min after volume infusion only in the HAES 200 patients. Systemic vascular resistance (SVR) decreased most markedly after infusion of HAES 200 (-34%; HAES 130: -18%). No further differences in gross haemodynamics could be seen after CPB. Plasma viscosity and colloid osmotic pressure increased in both HAES groups without significant differences. During the entire investigation period, pulmonary gas exchange (paO2) and Qs/Qt did not differ between the groups. Infusion of both HAES solutions resulted in an increase in LDF that was most pronounced after infusion of HAES 200 (forehead LDF: +81%; HAES 130: +18%) and was evident in the post-bypass period only in these patients (LDF: HAES 200: +82%; HAES 130: -20%; control: -43%). No correlation between LDF values and the other haemodynamic and laboratory parameters could be demonstrated. CONCLUSION. The improvement in macrohaemodynamics was of shorter duration after infusion of the new HAES 130 solution than after standard HAES 200. Volume replacement with HAES 200 resulted in an increase in microcirculatory blood flow that was more pronounced and of longer duration than in the HAES 130 patients. Thus, HAES 130 seems to be less effective than HAES 200 for volume replacement; HAES 200 should be preferred in patients undergoing cardiac surgery.

Cardiac Surgical Procedures↗
PubMed1991

Selection of thermotolerant yeasts for simultaneous saccharification and fermentation (SSF) of cellulose to ethanol.

A total of 27 yeast strains belonging to the groups Candida, Saccharomyces, and Kluyveromyces were screened for their ability to grow and ferment glucose at temperatures ranging 32-45 degrees C. K. marxianus and K. fragilis were found to be the best ethanol producing organisms at the higher temperature tested and, so, were selected for subsequent simultaneous saccharification and fermentation (SSF) studies. SSF experiments were performed at 42 and 45 degrees C, utilizing Solkafloc (10%) as cellulose substrate and a cellulase loading of 15 FPU/g substrate. Best results were achieved at 42 degrees C with K. marxianus L. G. and K. fragilis L. G., both of which produced close to 38 g/L ethanol and 0.5 ethanol yield, in 78 h.

Candida↗
PubMed1991

Cardiorespiratory responses to hypertonic saline solution in cardiac operations.

Infusion of small volumes of hypertonic saline solution (HS) seems to be of benefit in patients with impaired perfusion. The cardiorespiratory response to a 7.2% NaCl solution prepared in hydroxyethylstarch (HES) solution was investigated prospectively in patients undergoing prolonged cardiopulmonary bypass (CPB) (HS-HES group; n = 15); 6% HES 200/0.5 solution was infused in a control group (HES group; n = 15). Volume was given preoperatively to double low pulmonary artery occlusion pressure (less than 4 mm Hg) within 20 minutes. Hemodynamics, oxygen transport variables, and pulmonary gas exchange were studied before and after infusion as well as before and after CPB. Significantly less HS-HES solution (3.06 +/- 0.2 mL/kg) than 6% HES 200/0.5 solution (10.3 +/- 0.9 mL/kg) was necessary to double baseline pulmonary artery occlusion pressure. Fluid balance during CPB was negative in the HS-HES patients (-0.05 mL/kg.min CPB) and was lowest in this group even 5 hours after CPB. Mean arterial pressure, pulmonary arterial pressure, and heart rate were without differences between the groups. Changes in cardiac index (+40%) and total systemic resistance (-25%) were significantly most pronounced in the HS-HES patients, continuing even until the end of operation. Pulmonary gas exchange (arterial oxygen tension, intrapulmonary right-to-left shunting) was least compromised in these patients, particularly after bypass. Oxygen consumption was without difference between the groups; oxygen delivery increased significantly more in the HS-HES patients due to the larger increase in cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiopulmonary Bypass↗
PubMed1991

RETRACTED: Does the preparation of heparin influence anticoagulation during cardiopulmonary bypass?

Various preparations of heparin from different manufacturers are commercially available. The influence of bovine lung heparin (BLH) and porcine mucosal heparin (PMH) on anticoagulation and heparin plasma concentration was investigated in four groups of 10 patients undergoing elective aortocoronary bypass grafting either after single dose or repetitive dose (after 60 minutes) of one of these heparin preparations. Heparin plasma concentration increased significantly after injection of heparin (BLH: minimum, 1.67 U/mL; maximum, 2.10 U/mL; PMH: minimum, 1.69 U/mL; maximum, 2.15 U/mL). Sixty minutes after the initial dose, heparin plasma levels were higher in the patients who received PMH. Supplemental heparin doses 60 minutes after the loading dose increased plasma heparin concentration only with porcine mucosal heparin. Elimination of heparin in the urine was not different among the groups. Fibrinogen and antithrombin III concentrations, as well as activated clotting time (ACT; always greater than 400 seconds) and partial thromboplastin time (PTT; always greater than 300 seconds), did not differ among the groups, indicating effective anticoagulation during the bypass period with both types of heparin. It can be concluded that sufficient anticoagulation can be achieved with either kind of heparin. PMH seems to be longer acting and a repeat dose in these patients seems to be necessary only if cardiopulmonary bypass lasts longer than 90 minutes.

Aged↗