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

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dc.contributor.authorSoran Türkcan, Başak
dc.contributor.authorÜnal, Ertekin Utku
dc.contributor.authorKiriş, Erman
dc.contributor.authorAytekin, Bahadır
dc.contributor.authorAkkaya, Bekir
dc.contributor.authorDemir, Z. Aslı
dc.contributor.authorAykut, Aslıhan
dc.contributor.authorAksöyek, Ayşen
dc.contributor.authorBirincioğlu, Levent
dc.date.accessioned2022-09-30T11:01:23Z
dc.date.available2022-09-30T11:01:23Z
dc.date.issued2021
dc.departmentALKÜ
dc.description.abstractAim: 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.
dc.identifier.doi10.30565/medalanya.956769
dc.identifier.endpage288en_US
dc.identifier.issue2en_US
dc.identifier.startpage282en_US
dc.identifier.urihttps://dergipark.org.tr/tr/download/article-file/1840536
dc.identifier.urihttps://hdl.handle.net/20.500.12868/1733
dc.identifier.volume5en_US
dc.language.isoen
dc.relation.ispartofActa Medica Alanya
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Başka Kurum Yazarı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCardiac surgery
dc.subjectBlood transfusion
dc.subjectDrainage
dc.subjectReoperation
dc.subjectHeparin
dc.subjectTranexamic acid
dc.titleHeparin titration protocol with tranexamic acid in cardiac surgery: a pilot study
dc.typeArticle

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