title: An Adjusted Calculation Model of Reduced Heparin Doses in Cardiopulmonary Bypass Surgery in a Chinese Population.
abstract: OBJECTIVE
  To investigate the safety and efficacy of an adjusted regimen of heparin infusion in cardiopulmonary bypass (CPB) surgery in a Chinese population.
  
  
  METHODS
  Prospective, single-center, observational study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Patients having cardiac surgery with CPB were selected for this study using the following criteria: 18 to 75 years of age, undergoing first-time cardiac surgery with conventional median sternotomy, aortic clamping time between 40 and 120 minutes, and preoperative routine blood tests showing normal liver, renal, and coagulation functions. The exclusion criteria include salvage cases, a history of coagulopathy in the family, and long-term use of anticoagulation or antiplatelet drugs.
  
  
  METHODS
  Sixty patients were divided randomly into a control group (n = 30) receiving a traditional heparin regimen and an experimental group (n = 30) receiving an adjusted regimen.
  
  
  RESULTS
  Activated coagulation time (ACT) was monitored at different time points, ACT>480 seconds was set as the safety threshold of CPB. Heparin doses (initial dose, added dose, and total dose), protamine doses (initial dose, added dose, and total dose), CPB time, aortic clamping time, assisted circulation time, sternal closure time, blood transfusion volume, and drainage volume 24 hours after surgery were recorded. There was no significant difference in achieving target ACT after the initial dose of heparin between the 2 groups; CPB time, aortic clamping time, assisted circulation time, postoperative complication rate, and drainage volume between the 2 groups were not significantly different (p>0.05). However, initial and total dosage of heparin, initial and total dosage of protamine, sternal closure time, and intraoperative blood transfusion volume in the experimental group were significantly lower (p< 0.05).
  
  
  CONCLUSIONS
  Adjusted regimen of heparin infusion could be used safely and effectively in Chinese CPB patients, which might reduce the initial and total dosage of heparin and protamine as well as sternal closure time and intraoperative blood transfusion volume.
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xue
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Hong
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jibin
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lihui
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Ji
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jihong
authors.initials: J
authors.lastname: Sheng
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: zyf19810824@163.com.
authors.forename: Zhinong
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D000925:Anticoagulants / Q000008:administration & dosage; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass; D002681:China; D004305:Dose-Response Relationship, Drug; D006493:Heparin / Q000008:administration & dosage; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014914:Whole Blood Coagulation Time / Q000706:statistics & numerical data
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: activated clotting time; cardiopulmonary bypass, transfusions, protamine, anticoagulation; heparin; individual administration