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2011•Charles Sturt University Research Output (CRO)Open access

Individualised Heparin and Protamine Sulfate Management in Infants Undergoing Cardiac Surgery with Cardiopulmonary Bypass

Colleen Gruenwald

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Abstract

The use of the HMS device following the modified protocol resulted in more stable anti-Xa levels during CPB with improved post-operative outcomes including reduced need for transfusions (71 vs. 80ml/kg, p=0.003), ventilation time (33 vs. 49 hours, p=0.04), intensive care (88 vs. 99 hours, p=0.003) and hospital length of stay (192 vs. 216 hours, p<0.001), compared with the weight-based protocol. ConclusionsThe HMS device is unsuitable for neonates and infants undergoing CPB when used according to the manufacturer's instruction for use. This study supports the use of the HMS device, with a modified protocol for infants less than one year of age. Clinical guidelines for the use of the HMS device should be modified for infants less than one year of age.

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The use of the HMS device following the modified protocol resulted in more stable anti-Xa levels during CPB with improved post-operative outcomes including reduced need for transfusions (71 vs. 80ml/kg, p=0.003), ventilation time (33 vs. 49 hours, p=0.04), intensive care (88 vs. 99 hours, p=0.003) and hospital length of stay (192 vs. 216 hours, p<0.001), compared with the weight-based protocol. ConclusionsThe HMS device is unsuitable for neonates and infants undergoing CPB when used according to the manufacturer's instruction for use. This study supports the use of the HMS device, with a modified protocol for infants less than one year of age. Clinical guidelines for the use of the HMS device should be modified for infants less than one year of age.

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Available abstract

The use of the HMS device following the modified protocol resulted in more stable anti-Xa levels during CPB with improved post-operative outcomes including reduced need for transfusions (71 vs. 80ml/kg, p=0.003), ventilation time (33 vs. 49 hours, p=0.04), intensive care (88 vs. 99 hours, p=0.003) and hospital length of stay (192 vs. 216 hours, p<0.001), compared with the weight-based protocol. ConclusionsThe HMS device is unsuitable for neonates and infants undergoing CPB when used according to the manufacturer's instruction for use. This study supports the use of the HMS device, with a modified protocol for infants less than one year of age. Clinical guidelines for the use of the HMS device should be modified for infants less than one year of age.

Key concepts: Cardiopulmonary bypass, Heparin, Protamine sulfate, Protamine, Cardiac surgery, Medicine, Cardiology, Internal medicine

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Individualised Heparin and Protamine Sulfate Management in Infants Undergoing Cardiac Surgery with Cardiopulmonary Bypass — Research Paper | ScholarLens