A randomized study of beef lung and pork mucosal heparin in cardiac surgery

Beef lung heparin had substantially greater anticoagulant activity than pork mucosal heparin during a preoperative heparin tolerance test and also during cardiopulmonary bypass (CPB) in 100 randomized patients. Supplemental heparin was needed during CPB in many more of the patients receiving pork mucosal heparin. Heparin rebound was detected in 16 patients; this low incidence may result from a relatively high protamine:heparin ratio. There was notably less postoperative bleeding in those who received beef lung heparin. Platelet counts were not altered by either type of heparin. It is surprising that the preoperative tolerance curve only predicted heparin sensitivity during CPB in one-half of the patients. Blood activated coagulation time levels were increased markedly by hemodilution and further raised by hypothermia. These data demonstrate that beef lung heparin is better than pork mucosal heparin for CPB.