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2017 ; 49
(3
): 192-197
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Heparin: Effects upon the Glycocalyx and Endothelial Cells
#MMPMID28979043
Spiess BD
J Extra Corpor Technol
2017[Sep]; 49
(3
): 192-197
PMID28979043
show ga
Unfractionated heparin (UFH) is the most widely used injectable medication in the
United States. UFH is a poly-dispersed, relatively impure combination of many
polysaccharides known as a glycosaminoglycan. It is used as the primary
anticoagulant for heart surgery as well as for active treatment of deep venous
thrombosis, vascular thrombosis, stroke, and many other potentially catastrophic
clotting syndromes. Many perfusionists and cardiac team members know little of
the biology of UFH other than its use for cardiopulmonary bypass. UFH is very
similar to heparin sulfate, found on the surface of endothelial cells. Heparan
sulfate protects endothelial surfaces from inflammatory attack and serves as a
mechano-transducer for vascular shear. UFH and all glycosaminoglycans have far
reaching pleotropic actions. This review elaborates on some of fascinating unique
biology of these polysaccharides. Perhaps a number of the complex complications
attributed to CPB are either caused by, or set up to occur by the complicated
biology of UFH?
|Anticoagulants/pharmacology/therapeutic use
[MESH]