Does use of the Hepcon® point-of-care coagulation monitor to optimise heparin and protamine dosage for cardiopulmonary bypass decrease bleeding and blood and blood product requirements in adult patients undergoing cardiac surgery?

Interactive Cardiovascular and Thoracic Surgery

Volumn 5, Issue 4, 2006, Pages 469-482

  Abdul Aziz, Khairul Anuar ^a   Masood, Omar ^a   Hoschtitzky, J Andreas ^a   Ronald, Andrew ^b  

^a MANCHESTER ROYAL INFIRMARY   (United Kingdom)

^b ABERDEEN ROYAL INFIRMARY   (United Kingdom)

Author keywords

Blood products; Cardiac surgery; Cardiopulmonary bypass; Coagulation management; Heparin; Protamine

Indexed keywords

HEPARIN; PROTAMINE;

ARTICLE; BLEEDING; BLOOD; BLOOD CLOTTING; BLOOD CLOTTING TEST; CARDIOPULMONARY BYPASS; DEVICE; EMBASE; HEART SURGERY; HEMOSTASIS; HUMAN; MEDLINE; MONITOR; PRIORITY JOURNAL;

EID: 33746752738     PISSN: 15699293     EISSN: 15699293     Source Type: Journal    
DOI: 10.1510/icvts.2006.133785     Document Type: Article

References (15)

1. Dunning J, Prendergast B, Mackway-Jones K. Towards evidence-based medicine in cardiothoracic surgery: best BETS. Interact Cardiovasc Thorac Surg 2003;2:405-409.
2. Raymond PD, Ray MJ, Callen SN, Marsh NA. Heparin monitoring during cardiac surgery. Part 1: validation of whole blood heparin concentration and activated clotting time. Perfusion 2003;18:269-276.
3. Murray DJ, Brosnahan WJ, Pennell B, Kapalanski D, Weiler JM, Olson J. Heparin detection by the activated coagulation time: a comparison of the sensitivity of coagulation tests and heparin assays. J Cardiothorac Vasc Anesth 1997;11:24-28.
4. Yamanishi H, Watanabe S, Hayashi K, Tomioka H, Minami M, Nozaki Y, Aoki T, Kawai Y, Kishino K, Ohta S. A clinical evaluation of the Hepcon/HMS: a new device of monitoring hemostasis management during cardiopulmonary bypass. Kyobu Geka - Jpn J Thorac Surg 1997;50:459-62 (in Japanese).
5. Shigeta O, Kojima H, Hiramatsu Y, Jikuya T, Terada Y, Atsumi N, Sakakibara Y, Nagasawa T, Mitsui T. Low-dose protamine based on heparin-protamine titration method reduces platelet dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg 1999;118:354-360.
6. Despotis GJ, Joist JH, Hogue CW Jr, Alsoufiev A, Kater K, Goodnough LT, Santoro SA, Spitznagel E, Rosenblum M, Lappas DG. The impact of heparin concentration and activated clotting time monitoring on blood conservation. A prospective, randomized evaluation in patients undergoing cardiac operation. J Thorac Cardiovasc Surg 1995;110:46-54.
7. Despotis GJ, Joist JH, Hogue CW Jr, Alsoufiev A, Joiner-Maier D, Santoro SA, Spitznagel E, Weitz JI, Goodnough LT. More effective suppression of hemostatic system activation in patients undergoing cardiac surgery by heparin dosing based on heparin blood concentrations rather than ACT. Thrombosis & Haemostasis 1996;76:902-908.
8. Newsome J, Stipanovich K, Flaherty S. Comparison of heparin administration using the Rapidpoint Coag and Hepcon HMS. J Extra-Corporeal Technol 2004;36:139-144.
9. Sakurada T, Kikuchi Y, Koushima R, Nakashima S, Hachiro Y, Kagaya H. Clinical evaluation of heparin concentration and activated clotting time monitoring (HEPCON HMS) system. Nippon Kyobu Geka Gakkai Zasshi-J Jpn Assoc Thorac Surg 1997;45:836-840 (in Japanese).
10. Beholz S, Grubitzsch H, Bergmann B, Wollert H-G, Eckel L. Haemostasis management by use of the HepconyHMS®: increased bleeding without increased need for blood transfusion. Thorac Cardiovasc Surgeon 1999;47:322-327.
11. Ohata T, Sawa Y, Ohtake S, Nishimura M, Chan CJ, Suzuki K, Matsuda H. Clinical role of blood heparin level monitoring during open heart surgery. Nihon Kyobu Geka Gakkai zasshi-Jpn J Thorac Cardiovasc Surg 1999;47:600-606.
12. Koster A, Fischer T, Praus M, Haberzettl H, Kuebler WM, Hetzer R, Kuppe H. Hemostatic activation and inflammatory response during cardiopulmonary bypass: impact of heparin management. Anesthesiology 2002;97:837-841.
13. Avidan MS, Alcock EL, Da Fonseca J, Ponte J, Desai JB, Despotis GJ, Hunt BJ. Comparison of structured use of routine laboratory tests or near-patient assessment with clinical judgement in the management of bleeding after cardiac surgery. Br J Anaesth 2004;92:178-186.
14. Bennett KM, Briggins D, Zucker M, LaDuca F. A four-year experience with patient individualized heparin and protamine dosing using the Hemochron RxDx system. J Extra-Corporeal Technol 2001;33:19-22.
15. Shore-Lesserson L, Reich DL, DePerio M. Heparin and protamine titration do not improve haemostasis in cardiac surgical patients. Can J Anaesth 1998;45:10-18.