|Patients requiring re-operation through a previous median sternotomy.|
|Patients with infective endocarditis.|
The loading dose of 200 mL (2 million KIU) should be administered intravenously after induction of anaesthesia and prior to sternotomy. The initial 1 mL (10 000 KIU) should be administered slowly as a test dose over several minutes 10 minutes prior to the remainder of the dose, to assess the risk of allergic or pseudo-allergic reactions. The remainder of the loading dose should then be given as a slow intravenous infusion or injection over a period of 15-20 minutes.
The loading dose should be followed by the administration of a continuous infusion of 50 mL (500 000 KIU) per hour until the end of the operation except in patients with infective endocarditis where it may be continued into the early post-operative period.
|iii)||Pump prime dose|
An additional 200 mL (2 million KIU) should be added to the priming volume of the extracorporeal circuit. In patients with infective endocarditis 300 mL (3 million KIU) should be added to the pump prime.