• B Jude, D Lasne, C Mouton, P de Moerloose, Groupe de travail "Hémostase circulation extracorporelle", Groupe d'études sur l'hémostase et la thrombose, and Groupe d'intérêt en hémostase périopératoire.
• Institut d'hématologie biologique et d'hémobiologie-transfusion, CHRU de Lille, boulevard du Professeur-Leclercq, 59037 Lille, France. b-jude@chru-lille.fr
• Ann Fr Anesth Reanim. 2004 Jun 1; 23 (6): 589-96.

AbstractCardiac surgery with extracorporeal circulation induces major alterations of haemostasis and requires high level of anticoagulation, usually achieved by unfractionated heparin infusion. Optimization of anticoagulant regimen, through adapted biological monitoring, can probably improve postoperative course, at least for postoperative haemostatic status. Despite increasing knowledge on extracorporeal circulation-induced haemostatic abnormalities and the development of new biological devices for heparin monitoring, the optimal level of anticoagulation remains matter of debate, as well as the monitoring procedures. This critical review presents the current available data on heparin anticoagulation and monitoring in this specific context, and underlines the pending issues about anticoagulation management during extracorporeal bypass.

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