Abstract
The change in the heparin solution trade mark in Brazil that had been commonly used in cardiac surgery has shown increased number in the coagulopathy, re-exploration and other side effects in our Institution and others. All four different heparin solutions available in the Brazilian market were studied in the Connective Tissue Lab, HUCFF, UFRJ and compared to the Liquemine (out of the market) and the international control solution. All samples were evaluated by magnetic nuclear resonance as well as their anticoagulant effectiveness. There were significant differences among them regarding the anticoagulant activity. It was also observed contamination with other dermatan sulfate, samples chemically degraded and with significant change in the molecular weight. Among the studied samples, none of them can offer security in cardiac surgeries on pump. None of them has demonstrated similar quality to Liquemine, which is not available in the Brazilian market.
Highlights
The change in the heparin solution that had been commonly used in cardiac surgery in Brazil have shown increased number in the coagulopathy, re-exploration and other side effects in our Institution and others
The aim of this study was to evaluate the quality of heparin preparations available in the Brazilian market, as well as those that are currently used in cardiovascular surgeries with cardiopulmonary bypass
The aim is to attempt to obtain the same anticoagulant activity that those preparations considered ideal; that is, we found that the heparin in Preparations 4 and 5 present a specific activity (IU/mg), which is significantly lower than that observed in Preparation 1 (Liquemine)
Summary
The change in the heparin solution that had been commonly used in cardiac surgery in Brazil have shown increased number in the coagulopathy, re-exploration and other side effects in our Institution and others. Thanks to the discovery of heparin, we have seen one of the most important advances in the development of cardiac surgeries using cardiopulmonary bypass (CPB). This anticoagulant, routinely used during CPB, has the advantage of being very specific, of not producing anaphylaxis allergies. Non-fractionated heparin contains a mixture of polysaccharides with molecular weight between 3.000 and 30.000 Daltons. It acts in the final stage of coagulation cascade and concomitantly activates antithrombin and heparin cofactor II. Its antidote is protamine, which is widely used in cardiovascular surgery
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