Anticoagulation management in patients undergoing open heart surgery by activated clotting time and whole blood heparin concentration

Federico Pappalardo, Annalisa Franco, Giuseppe Crescenzi, Francesco de Simone, Lucia Torracca, Alberto Zangrillo

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the changes in perioperative anticoagulation management using a heparin-concentration-based system (HMS), and its effect on postoperative outcome. Methods: A total of 39 patients undergoing elective primary open heart surgery were randomly assigned to a heparin-concentration-based system approach (study group: 17 patients) or a standard ACT-based anticoagulation system (control group: 22 patients). Measurements and main results: Patients in the study group received a statistically significant higher dose of heparin (median 29 000 IU with IQR 22 500-33 500 IU versus median 19 000 IU with IQR 17 775-21 500 IU; p 9/L versus 125 ± 27 × 10 9/L, p =0.002). None of the study patients, but six patients in the control group required transfusion of blood products (p =0.02). No differences were recorded in postoperative antithrombin activity, bleeding, and other clinical outcomes. Conclusion: The HMS system, by facilitating maintenance of a stable heparin concentration, and by determining an appropriate dose of protamine, is associated with reduced platelet consumption and does not increase AT-III consumption and postoperative bleeding.

Original languageEnglish
Pages (from-to)285-290
Number of pages6
JournalPerfusion
Volume21
Issue number5
DOIs
Publication statusPublished - 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Advanced and Specialised Nursing
  • Safety Research

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