Prolonged Activated Clotting Time after Protamine Administration Does Not Indicate Residual Heparinization after Cardiopulmonary Bypass in Pediatric Open Heart Surgery

Thoracic and Cardiovascular Surgeon

Volumn 63, Issue 5, 2015, Pages 397-403

  Yamamoto, Tomohiro ^a   Wolf, Hans Gerd ^a   Sinzobahamvya, Nicodème ^a   Asfour, Boulos ^a   Hraska, Victor ^a   Schindler, Ehrenfried ^a  

^a German Pediatric Heart Center   (Germany)

Author keywords

blood; cardiopulmonary bypass; coagulation anticoagulation; congenital heart disease

Indexed keywords

BLOOD CLOTTING FACTOR 10; BLOOD CLOTTING FACTOR 5; BLOOD CLOTTING FACTOR 7; BLOOD CLOTTING FACTOR 8; FIBRINOGEN; HEPARIN; PROTAMINE; PROTHROMBIN; THROMBIN ANTITHROMBIN COMPLEX; ANTICOAGULANT AGENT; HEPARIN ANTAGONIST;

ACTIVATED CLOTTING TIME; ANTI XA ASSAY; BLOOD CLOTTING TIME; CARDIOPULMONARY BYPASS; CLINICAL ARTICLE; CONFERENCE PAPER; DRUG BLOOD LEVEL; HEMATOLOGY TEST KIT; HEMOCONCENTRATION; HEPARINIZATION; HUMAN; OPEN HEART SURGERY; OPTIMAL DRUG DOSE; OXYGENATOR; PEDIATRIC CARDIOLOGY; PEDIATRIC SURGERY; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; PUMP; SURGICAL PATIENT; THROMBOELASTOGRAPH; THROMBOELASTOGRAPHY; ADVERSE EFFECTS; BLOOD; BLOOD CLOTTING; CHILD; COHORT ANALYSIS; DRUG EFFECTS; FEMALE; FOLLOW UP; GERMANY; HEART DEFECTS, CONGENITAL; INFANT; MALE; POSTOPERATIVE CARE; PREOPERATIVE CARE; PRESCHOOL CHILD; PROCEDURES; RISK ASSESSMENT; TREATMENT OUTCOME;

ANTICOAGULANTS; BLOOD COAGULATION; CARDIOPULMONARY BYPASS; CHILD; CHILD, PRESCHOOL; COHORT STUDIES; FEMALE; FOLLOW-UP STUDIES; GERMANY; HEART DEFECTS, CONGENITAL; HEPARIN; HEPARIN ANTAGONISTS; HUMANS; INFANT; MALE; POSTOPERATIVE CARE; PREOPERATIVE CARE; PROTAMINES; RISK ASSESSMENT; THROMBELASTOGRAPHY; TREATMENT OUTCOME; WHOLE BLOOD COAGULATION TIME;

EID: 84939264060     PISSN: 01716425     EISSN: 14391902     Source Type: Journal    
DOI: 10.1055/s-0035-1554998     Document Type: Conference Paper

References (27)

1. Bull B. S., Huse W. M., Brauer F. S., Korpman R. A. Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage. J Thorac Cardiovasc Surg: 1975; 69 5 685 689
2. Shanewise J. S., Hug C. C. Anesthesia for adult cardiac surgery. In: Miller R. D., ed. Anesthesia. 5th ed. New York Churchill Livingstone: 2000; 1753 1805
3. Esposito R. A., Culliford A. T., Colvin S. B., Thomas S. J., Lackner H., Spencer F. C. The role of the activated clotting time in heparin administration and neutralization for cardiopulmonary bypass. J Thorac Cardiovasc Surg: 1983; 85 2 174 185
4. Pi K. D. Lack of correction between activated clotting time and plasma heparin during cardiopulmonary bypass. Ann Surg: 1983; 198 1 115
5. Despotis G. J., Summerfield A. L., Joist J. H., et al. Comparison of activated coagulation time and whole blood heparin measurements with laboratory plasma anti-Xa heparin concentration in patients having cardiac operations. J Thorac Cardiovasc Surg: 1994; 108 6 1076 1082
6. Guzzetta N. A., Monitz H. G., Fernandez J. D., Fazlollah T. M., Knezevic A., Miller B. E. Correlations between activated clotting time values and heparin concentration measurements in young infants undergoing cardiopulmonary bypass. Anesth Analg: 2010; 111 1 173 179
7. Ellison N., Ominsky A. J., Wollman H. Is protamine a clinically important anticoagulant? A negative answer. Anesthesiology: 1971; 35 6 621 629
8. Mochizuki T., Olson P. J., Szlam F., Ramsay J. G., Levy J. H. Protamine reversal of heparin affects platelet aggregation and activated clotting time after cardiopulmonary bypass. Anesth Analg: 1998; 87 4 781 785
9. Dunning J., Versteegh M., Fabbri A., et al. EACTS Audit and Guidelines Committee. Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur J Cardiothorac Surg: 2008; 34 1 73 92
10. Michelson A. D., MacGregor H., Barnard M. R., Kestin A. S., Rohrer M. J., Valeri C. R. Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb Haemost: 1994; 71 5 633 640
11. Wolberg A. S., Meng Z. H., Monroe D. M. III, Hoffman M. A systematic evaluation of the effect of temperature on coagulation enzyme activity and platelet function. J Trauma: 2004; 56 6 1221 1228
12. Dirkmann D., Hanke A. A., Görlinger K., Peters J. Hypothermia and acidosis synergistically impair coagulation in human whole blood. Anesth Analg: 2008; 106 6 1627 1632
13. Newall F. Anti-factor Xa (anti-Xa) assay. Methods Mol Biol: 2013; 992 265 272
14. Kamath B. S., Fozard J. R. Control of heparinisation during cardiopulmonary bypass. Experience with the activated clotting time method. Anaesthesia: 1980; 35 3 250 256
15. Akl B. F., Vargas G. M., Neal J., Robillard J., Kelly P. Clinical experience with the activated clotting time for the control of heparin and protamine therapy during cardiopulmonary bypass. J Thorac Cardiovasc Surg: 1980; 79 1 97 102
16. Beholz S., Grubitzsch H., Bergmann B., Wollert H. G., Eckel L. Hemostasis management by use of Hepcon/HMS: increased bleeding without increased need for blood transfusion. Thorac Cardiovasc Surg: 1999; 47 5 322 327
17. Guzzetta N. A., Bajaj T., Fazlollah T., et al. A comparison of heparin management strategies in infants undergoing cardiopulmonary bypass. Anesth Analg: 2008; 106 2 419 425, table of contents
18. Noui N., Zogheib E., Walczak K., et al. Anticoagulation monitoring during extracorporeal circulation with the Hepcon/HMS device. Perfusion: 2012; 27 3 214 220
19. Slight R. D., Buell R., Nzewi O. C., McClelland D. B., Mankad P. S. A comparison of activated coagulation time-based techniques for anticoagulation during cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth: 2008; 22 1 47 52
20. Haizinger B., Gombotz H., Rehak P., Geiselseder G., Mair R. Activated thrombelastogram in neonates and infants with complex congenital heart disease in comparison with healthy children. Br J Anaesth: 2006; 97 4 545 552
21. Miller B. E., Guzzetta N. A., Tosone S. R., Levy J. H. Rapid evaluation of coagulopathies after cardiopulmonary bypass in children using modified thromboelastography. Anesth Analg: 2000; 90 6 1324 1330
22. Romlin B. S., Wåhlander H., Berggren H., et al. Intraoperative thromboelastometry is associated with reduced transfusion prevalence in pediatric cardiac surgery. Anesth Analg: 2011; 112 1 30 36
23. Horkay F., Martin P., Rajah S. M., Walker D. R. Response to heparinization in adults and children undergoing cardiac operations. Ann Thorac Surg: 1992; 53 5 822 826
24. McDonald M. M., Jacobson L. J., Hay W. W. Jr, Hathaway W. E. Heparin clearance in the newborn. Pediatr Res: 1981; 15 7 1015 1018
25. Slaughter T. F., LeBleu T. H., Douglas J. M. Jr, Leslie J. B., Parker J. K., Greenberg C. S. Characterization of prothrombin activation during cardiac surgery by hemostatic molecular markers. Anesthesiology: 1994; 80 3 520 526
26. Miyashita T., Nakajima T., Hayashi Y., Kuro M. Hemostatic effects of low-dose protamine following cardiopulmonary bypass. Am J Hematol: 2000; 64 2 112 115
27. Nielsen V. G. Protamine enhances fibrinolysis by decreasing clot strength: role of tissue factor-initiated thrombin generation. Ann Thorac Surg: 2006; 81 5 1720 1727