Summary
Performance of cardiopulmonary bypass (CPB) during cardiac surgery requires the administration
of high dose heparin to prevent CPB pump occlusion. However, this heparin use is associated
with bleeding side-effects. Moreover, at the end of CPB, the heparin must be neutralized
with protamine sulphate, which is also associated with adverse side-effects. A number
of recent studies suggest that dermatan sulphate may be useful as an alternate anticoagulant
to heparin. We determined whether CPB could be performed using dermatan sulphate instead
of heparin, in an adult pig CPB model. When heparin was used, a high dose (> 200 U/kg,
which generated > 3 anti-thrombin U/ml of plasma), was required to perform successful
CPB and to maintain CPB pump patency. This dose was associated with a post CPB bleeding
of ≈ 600 ml/2h. in contrast, successful CPB could be achieved when the pigs were given
lower doses of dermatan sulphate than heparin, which in turn, were associated with
less bleeding. We conclude that dermatan sulphate may be an alternate anticoagulant
for cardiac surgery
