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.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
- Advanced and Specialised Nursing
- Safety Research