Title : Application of goal-directed therapy for the use of concentrated antithrombin for heparin resistance during cardiac surgery.

Pub. Date : 2021 Mar

PMID : 32536326






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1 Application of goal-directed therapy for the use of concentrated antithrombin for heparin resistance during cardiac surgery. Heparin serpin family C member 1 Homo sapiens
2 The purpose of this study was to evaluate a goal-directed approach for the use of antithrombin in patients who were resistant to heparin. Heparin serpin family C member 1 Homo sapiens
3 A goal-directed protocol for antithrombin was established based upon heparin dosing (400 IU kg-1 body weight) and achieving an activated clotting time of >=500 seconds prior to cardiopulmonary bypass. Heparin serpin family C member 1 Homo sapiens
4 Patients in the antithrombin group were on preoperative heparin therapy (80.0% vs. 24.6%, p = 0.001). Heparin serpin family C member 1 Homo sapiens
5 Antithrombin patients had a lower heparin sensitivity index (0.55 +- 0.17 vs. 1.05 +- 0.44 seconds heparin-1 IU kg-1, p = 0.001), received more total heparin (961.3 +- 158.5 IU kg-1 vs. 677.5 +- 199.0 IU kg-1, p = 0.001), more cardiopulmonary bypass heparin (22,500 +- 10,300 IU vs. 12,100 +- 13,200 IU, p = 0.016), and more protamine (5.4 +- 1.2 vs. 4.1 +- 1.1 mg kg-1, p = 0.003). Heparin serpin family C member 1 Homo sapiens
6 Antithrombin patients had a lower heparin sensitivity index (0.55 +- 0.17 vs. 1.05 +- 0.44 seconds heparin-1 IU kg-1, p = 0.001), received more total heparin (961.3 +- 158.5 IU kg-1 vs. 677.5 +- 199.0 IU kg-1, p = 0.001), more cardiopulmonary bypass heparin (22,500 +- 10,300 IU vs. 12,100 +- 13,200 IU, p = 0.016), and more protamine (5.4 +- 1.2 vs. 4.1 +- 1.1 mg kg-1, p = 0.003). Heparin serpin family C member 1 Homo sapiens
7 Antithrombin patients had a lower heparin sensitivity index (0.55 +- 0.17 vs. 1.05 +- 0.44 seconds heparin-1 IU kg-1, p = 0.001), received more total heparin (961.3 +- 158.5 IU kg-1 vs. 677.5 +- 199.0 IU kg-1, p = 0.001), more cardiopulmonary bypass heparin (22,500 +- 10,300 IU vs. 12,100 +- 13,200 IU, p = 0.016), and more protamine (5.4 +- 1.2 vs. 4.1 +- 1.1 mg kg-1, p = 0.003). Heparin serpin family C member 1 Homo sapiens
8 Antithrombin patients had a lower heparin sensitivity index (0.55 +- 0.17 vs. 1.05 +- 0.44 seconds heparin-1 IU kg-1, p = 0.001), received more total heparin (961.3 +- 158.5 IU kg-1 vs. 677.5 +- 199.0 IU kg-1, p = 0.001), more cardiopulmonary bypass heparin (22,500 +- 10,300 IU vs. 12,100 +- 13,200 IU, p = 0.016), and more protamine (5.4 +- 1.2 vs. 4.1 +- 1.1 mg kg-1, p = 0.003). Heparin serpin family C member 1 Homo sapiens
9 Utilization of a goal-directed algorithm for the administration of antithrombin for the treatment of heparin resistance is effective in patients undergoing cardiac surgery. Heparin serpin family C member 1 Homo sapiens