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[Sequential changes in haemostatic activity during prolonged surgery and its alteration with continuous heparin
Y Takasugi1, C Arai, M Sumitomo
1Department of Anesthesiology, Nippon Dental University, School of Dentistry at Tokyo, Tokyo 102-8158.
Masui. the Japanese Journal of Anesthesiology
|September 14, 2001
Summary
Continuous heparin infusion effectively suppresses hypercoagulable states during prolonged oral cancer surgeries. This study monitored hemostatic markers, showing heparinization inhibited detrimental changes in the heparin group compared to controls.
Area of Science:
- Biomedical Science
- Surgical Oncology
- Hematology
Background:
- Prolonged surgeries, especially for oral cancers, pose risks of hypercoagulable states.
- Monitoring hemostatic activity is crucial during extensive surgical procedures.
Purpose of the Study:
- To investigate the impact of continuous intraoperative heparin infusion on hemostatic markers.
- To assess the efficacy of heparin in preventing hypercoagulability during long surgeries.
Main Methods:
- Patients undergoing oral cancer surgeries (>10 hours) were divided into heparin and control groups.
- Heparin was infused to maintain activated partial thromboplastin time (aPTT) between 50-70 seconds.
- Molecular markers including thrombin-antithrombin III complex (TAT), fragment 1 + 2 (F1 + 2), D-dimer, and SFMC were measured.
Main Results:
- In the control group, TAT, F1 + 2, D-dimer increased, and SFMC became positive.
- Continuous heparinization significantly inhibited these procoagulant marker elevations.
- Hemostatic activity increased progressively, but heparin infusion suppressed the hypercoagulable state.
Conclusions:
- Intraoperative continuous heparin infusion is effective in managing hypercoagulable states during prolonged oral cancer surgeries.
- Heparinization helps maintain hemostatic balance, reducing risks associated with extended surgical times.