Mohri H, Ishitoya T, Hessel E A, Schmer G, Dillard D H, Merendino K A
J Thorac Cardiovasc Surg. 1979 Feb;77(2):277-82.
A method of heparinless, oxygenatorless, left heart bypass perfusion rewarming following surface hypothermia, with the use of a closed circuit with 130 ml. prime volume including heat exchanger, has been devised. The use of polyurethane-polyvinyl-graphite (PPG)-coated tubing has previously been reported. In this text, the use of an athrombogenic coating with cetyl-pyridinium chloride (CPC) as a regional heparin carrier was studied in dogs, comparing groups with PPG tubing and total systemic heparinization or plain polyvinyl tubing without systemic heparinization. Heparin compounded in the CPC coating eluted into the blood and caused mild transient whole-body heparinization during rewarming from 20 degrees to 25 degrees C., as evidenced by prolongation of the thrombin time. Alterations of hematologic parameters in all three groups were similar to those during surface rewarming except for those affected by heparinization. The left heart bypass method was found useful for hypothermic open-heart surgery when utilized with an athrombogenic surface coating or total body heparinization. It was concluded that the CPC coating is superior to the PPG coating since no cracking surface develops, it is translucent, and it provides a more effective athrombogenic surface.
已经设计出一种在体表低温后进行无肝素、无氧合器、左心转流灌注复温的方法，该方法使用一个包含热交换器的130毫升预充量的闭合回路。此前已有关于使用聚氨酯 - 聚乙烯 - 石墨（PPG）涂层管道的报道。在本文中，研究了以十六烷基吡啶氯化物（CPC）作为局部肝素载体的抗血栓形成涂层在犬类中的应用，并将其与使用PPG管道且全身肝素化的组以及未全身肝素化的普通聚乙烯管道组进行比较。CPC涂层中复合的肝素洗脱到血液中，并在从20℃复温至25℃的过程中引起轻度短暂的全身肝素化，凝血酶时间延长证明了这一点。除了受肝素化影响的参数外，所有三组血液学参数的变化与体表复温期间的变化相似。发现左心转流方法在与抗血栓形成表面涂层或全身肝素化一起使用时，对低温心脏直视手术有用。得出的结论是，CPC涂层优于PPG涂层，因为它不会出现表面开裂，是半透明的，并且提供了更有效的抗血栓形成表面。
