Clinical guidance for unfractionated heparin dosing and monitoring in critically ill patients

Samimi, May N.; Hale, Andrew; Schults, Jessica; Fischer, Andreas; Roberts, Jason A.; Dhanani, Jayesh

doi:10.1080/14656566.2024.2364057

Expert Opinion on Pharmacotherapy

2024

DOI: 10.1080/14656566.2024.2364057

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Clinical guidance for unfractionated heparin dosing and monitoring in critically ill patients

May N. Samimi,

Andrew Hale,

Jessica Schults

et al.

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2024

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A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas

Wei,

Wang,

Tian

et al. 2024

Perfusion

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Introduction There is no consensus on the dose of heparin to be used intraoperatively in cardiac myxomas, so the goal of this study was to look into the differences in the clinical effects on the perioperative period of patients with cardiac myxomas when different doses of heparin were used intraoperatively. Methods and Analysis 70 patients who had cardiac myxomas excision via cardiopulmonary bypass between January 2024 and July 2024. The 70 patients were separated into two groups based on the heparin dose administered prior to cardiopulmonary bypass heparinization. 42 patients in group A had a dose of ≤400 U/kg, while 28 patients in group B received a dose of >400 U/kg. Result PT, INR, and APTT were significantly prolonged in patients with cardiac myxomas in group A in the postoperative period 24 h after surgery, which was statistically significant ( P < .05) compared with that in group B. Intraoperative heparin dose appeared to influence changes in coagulation at 24 h postoperatively, but was mainly dominated by APTT. Also, heparinized doses showed a weak positive correlation with 24-h postoperative drainage volume. In addition, the dimension of the cardiac myxomas appeared to have some correlation with the patient’s preoperative APTT and age. Conclusion When patients with cardiac myxomas were heparinized intraoperatively with varying doses of heparin, the enhancement of coagulation in the 24 h after surgery was more pronounced in the group given higher doses of heparin, and endogenous coagulation pathways were activated much more than exogenous coagulation pathways in the 24 h after surgery.

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A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas

Wei,

Wang,

Tian

et al. 2024

Perfusion

View full text Add to dashboard Cite

show abstract

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Clinical guidance for unfractionated heparin dosing and monitoring in critically ill patients

Cited by 1 publication

References 155 publications

A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas

A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas

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