[HSF] HIT and CPB

[EPS-CCV]

Hal, our protocol is as follows:

* Aprotinin (2 million KIU iv loading dose, 2 million KIU into the pump prime volume and 500,000 KIU per hour as continuous iv infusion).
* After induction of anesthesia: Continuous infusion of epoprostenol sodium (FLOLAN) is started at a rate of 5 ng/kg/min, infusion rate increased by stages of 5 ng/kg every 5 minutes until the infusion rate of 30 ng/kg/min is reached. At this time
* Standard heparin dose (bolus of 300 U/kg IV).
* CPB is started when ACT exceeds 480-500 seconds and after weaning from CPB, heparin is reversed with protamine. 
* Norepinephrine (0.05 to 0.1 microg/kg/min) is infused when required.

Epoprostenol sodium infusion is mantained until rewarming is begun. Then it is decreased by stages of 5 ng/kg every 5 minutes until stopped.


Enrique P. de la Sota MD, FETCS
Madrid (Spain)