Effect of Celox® Powder on Initial Hemostasis After Cardiac Catheterization in Pediatric Patients with Congenital Heart Disease: A Prospective Study

Abstract

<jats:p>Background: Ordinary pressure dressing for hemostasis after cardiac catheterization is time consuming and might cause some problems, such as pain or loss of blood, which has to be controlled, particularly in pediatric patient. Using Celox® (chitosan) powder dressing might cause quicker initial hemostasis. Methods: In this prospective study, we assessed Celox® powder among patients in hospitals affiliated with Shiraz University of Medical Sciences, from November 2017 to February 2018. The patients were stratified in two groups. The case group included patients for whom Celox® powder was used along with sterile gauze pressure at the puncture site to achieve hemostasis, and the control group those in whom hemostasis was achieved by standard sterile gauze pressure method. Results: Sixty patients under 16 years of age with congenital heart diseases were evaluated and underwent cardiac catheterization. We stratified the patients in two groups called case (30 patients) and control group (30 patients). Considering both arterial and venous initial hemostasis, in the case group, the minimum and maximum, median and mean coagulation time were less than those in the control group; however, the initial hemostasis was statistically significant only in venipuncture site. Also, the venous coagulation time was shorter among the patients weighing less than 10 kilograms in comparison to those with higher weight. In the case group, using Celox® stirred hemostasis toward the lower percentiles, but based on 50th percentile, the distribution in each group was identical. Conclusions: Celox® powder dressing in children led to reduced coagulation time in venipuncture site, and we might recommend utilizing this type of dressing for venous hemostasis in children after venipuncture.</jats:p>

The Efficacy of Chitosan Hemostatic Pad on Hemostatic Function in Patients Undergoing Cardiac Catheterization: A Systematic Review and Meta-Analysis

“…Time to hemostasis at the arterial puncture site: Review of the results of the five studies showed that Arbel et al [Arbel 2011] and Nguyen et al [Nguyen 2007] measured the continuous time to hemostasis at the arterial puncture sites and found that the time to hemostasis in the EG was significantly shorter than in the CG (mean=5.6±2.1, P < 0.001, ChitoSeal=16.2±4.9, CloSurPAD=16.0±5.3, P = 0.005). However, in a study by Amoozgar et al [Amoozgar 2020], there was no significant difference in the time to arterial hemostasis between the two groups (EG:17.2, CG:20.3, P = 0.77). Other studies classified the time to hemostasis as categorical data.…”

“…Arbel et al [Arbel 2011], Nguyen et al [Nguyen 2007], and Amoozgar et al [Amoozgar 2020] collected continuous The Heart Surgery Forum #2021-3997 E838 data on the time to hemostasis at arterial puncture sites, and according to our meta-analysis, the heterogeneity between the studies was high (I 2 = 52%). The overall effect showed that the diamond was biased toward the EG with added chitin hemostatic patches, indicating that the time to hemostasis at arterial puncture sites was significantly reduced (Std.…”

“…All the five articles were RCTs. However, Arbel et al [Arbel 2011], Nguyen et al [Nguyen 2007], and Amoozgar et al [Amoozgar 2020] did not clearly explain whether their assignment sequences were blinded, which led to some doubts regarding the research quality. In addition to the blindness in the randomization method and grouping, the first aspect also emphasizes interpretation of articles when there are differences in baseline values.…”

“…At last, the overall research risk assessment showed that the studies of Kang et al [Kang 2017] and Dai et al [Dai 2015] both had low risk, while those of Arbel et al [Arbel 2011], Nguyen et al [Nguyen 2007], and Amoozgar et al [Amoozgar 2020] were rated as having some doubts in research quality because the articles do not specify whether the assignment sequence was blinded. The research quality risk assessment for the studies with doubts in research quality is shown in Table 3.…”

Prevalence of iron deficiency anaemia in congenital heart disease in children

“…Everyday practice often overlooks or underdiagnoses anaemia in children with congenital heart disease (CHD), particularly in cyanotic youngsters who exhibit elevated haematocrit values as a result of persistent hypoxia. 12,13 The present study is thus conducted to find out the prevalence of iron deficiency anaemia in children less than 15 years with congenital heart disease at a tertiary care centre and compare them with cases without congenital heart disease.…”