Heparin dose calculated according to lean body weight during on-pump heart surgery

Aykut, Aslıhan; Sabuncu, Ülkü; Demir, Zeliha Aslı; Balcı, Eda; Türkcan, Başak Soran; Ünal, Utku; Özgök, Ayşegül

doi:10.5606/tgkdc.dergisi.2018.16497

Cited by 7 publications

(8 citation statements)

References 15 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other potential conflicts are inherent inaccuracy of the device and variances at ex vivo heparin activity [23]. Another method for heparin dosing strategy may be the calculation of heparin via lean body weight [24]. However, this approach should, similarly, be developed with regards to large-scale trials.…”

Section: Discussionmentioning

confidence: 99%

Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aim: Postoperative bleeding related to cardiac surgery is a clinically important condition. Consequently, re-exploration and increased blood utilization lead to adverse outcomes. The aim of this pilot study was to assess the effect of a newly adapted blood conservation strategy, including heparin titration protocol along with antifibrinolytics, regarding to mediastinal bleeding, re-exploration for bleeding and blood and blood products utilization.Methods: This study included 100 patients undergoing cardiac surgery with higher risk for bleeding, such as mitral valve replacement, aortic valve replacement, ascending / arcus aortic surgery, between January 2015 and August 2016. The study group consisted of consecutive patients who underwent new protocol (heparin titration protocol + tranexamic acid). The control group consisted of patients who were administered standard dose heparin(4 mg/kg). Fifty patients in each group (with the new protocol and the standard protocol) were compared by means of amount of heparin applied, blood utilization, mediastinal drainage and rate of re-exploration.Results: Twenty-eight of the 50 study group patients (56%) received a red blood cell (RBC) transfusion for the first 24 hours. RBC transfusion ≥ 3 units was lower in the study group (34% vs 54%; p=0.044). Moreover, mediastinal drainage and blood utilization was found to be lower at the study group, however re-exploration rates remained similar.Conclusion: Based on our study results, the suggested heparin titration protocol seemed to be beneficial for reducing postoperative bleeding and blood product usage. We consider that blood utilization protocols like our heparin titration protocol should be established to reduce the need for blood transfusion in cardiac surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Yet, there is no strong evidence to prove the hypothesis, at least in the field of cardiac surgery. Recently, Aykut, et al published an original article based on UFH dose calculation according to the estimated lean body weight, which represents body weight without body fat weight (14) . As a result of their study, there is no statistically significant difference between the actual body weight and lean body weight groups regarding bleeding after cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Negative Correlation Between Body Mass Index and Chest Tube Out-put After Coronary Artery Bypass Graft Surgery

Aksüt¹,

Çeli̇k²,

Günay³

et al. 2019

Kosuyolu Heart Journal

View full text Add to dashboard Cite

Introduction: The obvious threat of obesity to human life is well-known, but some contradictory outcomes have been encountered during previous medical research. Interestingly, obesity was recognized as a protective factor for some specific obesity-related situations. We aimed to correlate increased body mass index (BMI) and chest tube output after coronary artery bypass grafting (CABG). Patients and Methods: We retrospectively collected data of 421 patients who underwent isolated CABG surgery between dates of December 2015 and December 2016. Obtained BMI values were grouped into: underweight (< 20 kg/m 2), normal weight (20-25 kg/m 2), overweight (25-30 kg/m 2), obese (30-35 kg/m 2), and severely obese (> 35 kg/m 2) subclasses. The postoperative chest tube output volume corresponded drainage at first 24 hours after the CABG surgery. Results: The mean age was 61.6 (± 1.06) years. Female to male ratio was found 40, 9/59, 6 (n= 170/251). The patient population was divided into 2 groups as BMI below and above 30 kg/m 2 to approximately evaluate the relation between BMI and chest tube output. Overall, 193 patients were in the non-obese group, and 136 patients were in the obese group. The mean drainage amounts of non-obese and obese groups were 630 ± 360 and 463 ± 303 mL, respectively. We ran independent t-test to evaluate the relationship between BMI and chest tube output. It was statistically significant. The relationship between drainage and five different BMI subgroups was evaluated. Analysis of variance (ANOVA) showed statistically significant chest tube output difference between the normal and obese groups as well as the severely obese group. Conclusion: BMI is negatively correlated with bleeding after CABG surgery and should be considered in future bleeding prediction systems.

show abstract

“…Treatment medium contained the heparin concentrations detailed in Table . One control group was medium only, while the other control group contained 30 μg/mL heparin, an estimate of heparin concentration during surgery . The medium was replaced at 8, 24, and 48 h. XTT was conducted as described above at 24 and 48 h. Immunostaining and quantification were completed as described above at 48 h. Tissue factor pathway inhibitor (TFPI) was quantified with DuoSet ELISA kit (R&D Systems, Minneapolis, MN) according to the manufacturer’s protocol.…”

Section: Materials and Methodsmentioning

confidence: 99%

Long-Term Sustained Drug Delivery via 3D Printed Masks for the Development of a Heparin-Loaded Interlayer in Vascular Tissue Engineering Applications

Kimicata

Mahadik

Fisher

2021

ACS Appl. Mater. Interfaces

View full text Add to dashboard Cite

Current approaches in small-diameter vascular grafts for coronary artery bypass surgeries fail to address physiological variations along the graft that contribute to thrombus formation and ultimately graft failure. We present an innovative interlayer drug delivery system that can be utilized for the sustained delivery of heparin through a graft with a high degree of temporal and spatial control. A heparin-loaded gelatin methacrylate (gelMA) interlayer sits within a biohybrid composed of decellularized bovine pericardium (dECM) and poly(propylene fumarate) (PPF), and its UV crosslinking is controlled via three-dimensional (3D) printed shadow masks. The masks can be readily designed to modulate the incident light intensity on the graft, enabling us to control the resultant gelMA crosslinking and properties. A high heparin loading efficiency was obtained in gelMA and was independent of crosslinking. We achieved sustained heparin release over the course of 2 weeks within the biohybrid material using the 3D printed mask patterns. High doses of heparin were observed to have detrimental effects on endothelial cell function. However, when exposed to heparin in a slower, more sustained manner consistent with the masks, endothelial cells behave similarly to untreated cells. Further, slower release profiles cause significantly more release of tissue factor pathway inhibitor, an anticoagulant, than a faster release profile. The heparin-loaded gelMA interlayer we have developed is a useful tool for the temporal and spatial control of heparin release that supports endothelial function and promotes an antithrombotic environment.

show abstract

Heparin dose calculated according to lean body weight during on-pump heart surgery

Cited by 7 publications

References 15 publications

Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study

Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study

Negative Correlation Between Body Mass Index and Chest Tube Out-put After Coronary Artery Bypass Graft Surgery

Long-Term Sustained Drug Delivery via 3D Printed Masks for the Development of a Heparin-Loaded Interlayer in Vascular Tissue Engineering Applications

Contact Info

Product

Resources

About