Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study
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info:eu-repo/semantics/openAccessDate
2021Author
Soran Türkcan, BaşakÜnal, Ertekin Utku
Kiriş, Erman
Aytekin, Bahadır
Akkaya, Bekir
Demir, Z. Aslı
Aykut, Aslıhan
Aksöyek, Ayşen
Birincioğlu, Levent
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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.
Source
Acta Medica AlanyaVolume
5Issue
2URI
https://dergipark.org.tr/tr/download/article-file/1840536https://hdl.handle.net/20.500.12868/1733