Abstract:Evidence about the lack of dose interchangeability between bovine and porcine heparins and the unique safety profile of these drugs indicates the need to follow the treatment and the patients' response. Events threatening the patient's safety must be reported to the pharmacovigilance system in each particular country.
“…Heparin, even with low dose, can cause thrombocytopenia and bleeding [6]. The absolute risk of heparin-induced thrombocytopenia (HIT) with unfractionated heparin is 1%-5% [7]. Normal or isotonic saline has sodium and chloride concentrations of 154 mEq/L [8].…”
Introduction: Arterial catheters are widely used in intensive care units for continuous blood pressure monitoring and blood sampling. The patency of these lines is maintained by continuous flushing, usually with the addition of the anticoagulant heparin to the flushing solution. Normal saline solution can maintain patency of arterial and central venous pressure monitoring catheters. Aim of the Study: The aim of this study was to evaluate the effect between normal saline and heparin solution in arterial line flushing on platelet count. Methods: This was a prospective cross- sectional study conducted in the Department of Cardiac surgery of National Institute of Cardiovascular Disease (NICVD), Sher-E-Bangla Nagar, Dhaka, Bangladesh during the period from July 2016 to June 2017. This study included sixty patients who underwent single valve replacement surgery and shifted to the ICU with arterial line catheter. The patients who fulfilled the inclusion criteria were divided into two groups- Group A (with heparin solution) and Group B (with normal saline). Result: In total 60 patients from both the groups completed the study. In our study we found the mean ± SD of age among group A & B was (36.3±6.7) & (35.7±10.3) respectively. We found the mean± SD of platelet count at 1st POD was (206530±64441) & (212543±48768); at 3rd POD was (226517±60185) & (245957±52826); at 7th POD was (240517±57379) & (257713±53655); at 14th POD was (245850±52680) & (244337±56796) in Group A & B respectively. Conclusion: In our study we didn’t find any statistically significant difference regarding the patients’ demographic characteristics and there were no statistically significant difference of platelet counts between Group A and Group B at preoperative period, post pump, 1st POD, 2nd POD, 3rd POD, 4th POD, 7th POD and 14th POD.
“…Heparin, even with low dose, can cause thrombocytopenia and bleeding [6]. The absolute risk of heparin-induced thrombocytopenia (HIT) with unfractionated heparin is 1%-5% [7]. Normal or isotonic saline has sodium and chloride concentrations of 154 mEq/L [8].…”
Introduction: Arterial catheters are widely used in intensive care units for continuous blood pressure monitoring and blood sampling. The patency of these lines is maintained by continuous flushing, usually with the addition of the anticoagulant heparin to the flushing solution. Normal saline solution can maintain patency of arterial and central venous pressure monitoring catheters. Aim of the Study: The aim of this study was to evaluate the effect between normal saline and heparin solution in arterial line flushing on platelet count. Methods: This was a prospective cross- sectional study conducted in the Department of Cardiac surgery of National Institute of Cardiovascular Disease (NICVD), Sher-E-Bangla Nagar, Dhaka, Bangladesh during the period from July 2016 to June 2017. This study included sixty patients who underwent single valve replacement surgery and shifted to the ICU with arterial line catheter. The patients who fulfilled the inclusion criteria were divided into two groups- Group A (with heparin solution) and Group B (with normal saline). Result: In total 60 patients from both the groups completed the study. In our study we found the mean ± SD of age among group A & B was (36.3±6.7) & (35.7±10.3) respectively. We found the mean± SD of platelet count at 1st POD was (206530±64441) & (212543±48768); at 3rd POD was (226517±60185) & (245957±52826); at 7th POD was (240517±57379) & (257713±53655); at 14th POD was (245850±52680) & (244337±56796) in Group A & B respectively. Conclusion: In our study we didn’t find any statistically significant difference regarding the patients’ demographic characteristics and there were no statistically significant difference of platelet counts between Group A and Group B at preoperative period, post pump, 1st POD, 2nd POD, 3rd POD, 4th POD, 7th POD and 14th POD.
“…A heparina é um polissacarídeo ácido que pertence à família dos glicosaminoglicanos e sua estrutura foi elucidada através da degradação enzimática sequencial da molécula (GARCIA et al, 2011). A heparina sódica é um importante fármaco anticoagulante utilizado na cirurgia cardíaca.…”
“…As hemorragias nos pacientes críticos preocupam, pois em função da sua origem e do volume de sangue comprometido, podem potencializar a instabilidade hemodinâmica e ventilatória, aumentar a mortalidade e o tempo de permanência em unidades intensivas. 6 Nas unidades de terapia intensiva, estima-se que 5 a 10% desses pacientes apresentam algum tipo de sangramento im-portante. O impacto que esses eventos hemorrágicos têm sobre o prognóstico torna necessária a identificação de fatores de risco que possam contribuir para sua ocorrência.…”
Section: Introductionunclassified
“…Os mais citados são os seguintes: idade superior a 60 anos, hipertensão arterial sistêmica (HAS), insuficiência hepática e renal, uso prévio de anticoagulantes orais e o tempo de atividade de protrombina (PTTa) maior que 100 segundos. 2,4,6 A contribuição desta publicação se fundamenta no fato de que cabe ao enfermeiro o cuidado ao paciente anticoagulado, sendo, portanto, sua responsabilidade reconhecer quais fatores de risco estão mais associados a sangramento. Assim, poderá contribuir para um planejamento de cuidados específicos e mais seguros ao paciente anticoagulado, possibilitando a prevenção de eventos hemorrágicos que possam comprometer a evolução clínica do paciente.…”
Objetivo: analisar os fatores de risco relacionados à ocorrência de eventos hemorrágicos em pacientes anticoagulados. Método: trata-se de estudo de coorte retrospectivo, a partir de análise documental. Foram investigados 867 prontuários de pacientes internados em 2011 e 2012, encontrandose amostra de 79 pacientes que fizeram uso de heparina sódica em infusão contínua. Para quantificar a probabilidade do evento hemorrágico a partir dos diferentes fatores de risco, foram realizados tratamentos estatísticos não paramétricos e medidas de associação. Resultados: foi evidenciada taxa de 21,52% (n=17) eventos hemorrágicos. Dos 17 pacientes com eventos hemorrágicos, 94, 11% apresentaram um ou mais fatores de risco, com prevalência para: tempo de tromboplastina parcial ativada superior a 100 segundos (88,24%); idade maior que 60 anos (70,59%) e hipertensão arterial 64,71%. Pacientes com tempo de tromboplastina parcial ativada elevada apresentaram risco 9,29 vezes maior para eventos hemorrágicos (p=0,0008). Conclusões: entre os seis fatores de risco analisados, cinco tiveram associação positiva com sangramento. Os cuidados de enfermagem fundamentados na identificação dos fatores de risco previnem eventos hemorrágicos, aumentando a segurança na utilização de anticoagulantes com consequente melhora da qualidade da assistência de enfermagem.
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