Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study
Aim: 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 ti...
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| Format: | Article |
| Language: | English |
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Alanya Alaaddin Keykubat University
2021-12-01
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| Series: | Acta Medica Alanya |
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| Online Access: | https://dergipark.org.tr/tr/download/article-file/1840536 |
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| author | Aslıhan Aykut Bahadır Aytekin Başak Soran Türkcan Ertekin Utku Ünal Erman Kiriş Bekir Akkaya Z.aslı Demir Ayşen Aksöyek Levent Bırıncıoğlu |
| author_facet | Aslıhan Aykut Bahadır Aytekin Başak Soran Türkcan Ertekin Utku Ünal Erman Kiriş Bekir Akkaya Z.aslı Demir Ayşen Aksöyek Levent Bırıncıoğlu |
| author_sort | Aslıhan Aykut |
| collection | DOAJ |
| description | Aim: 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. |
| format | Article |
| id | doaj-art-932e849ba18e43b4aeee3b6cda057c55 |
| institution | OA Journals |
| issn | 2587-0319 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | Alanya Alaaddin Keykubat University |
| record_format | Article |
| series | Acta Medica Alanya |
| spelling | doaj-art-932e849ba18e43b4aeee3b6cda057c552025-08-20T02:29:30ZengAlanya Alaaddin Keykubat UniversityActa Medica Alanya2587-03192021-12-015328228810.30565/medalanya.956769727Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot studyAslıhan Aykut0https://orcid.org/0000-0003-0382-3494Bahadır Aytekin1https://orcid.org/0000-0003-4275-0072Başak Soran Türkcan2https://orcid.org/0000-0002-0694-5211Ertekin Utku Ünal3https://orcid.org/0000-0002-1144-8906Erman Kiriş4https://orcid.org/0000-0002-8550-0922Bekir Akkaya5https://orcid.org/0000-0002-3167-8434Z.aslı Demir6https://orcid.org/0000-0003-3053-0443Ayşen Aksöyek7https://orcid.org/0000-0001-7306-0459Levent Bırıncıoğlu8https://orcid.org/0000-0002-4660-1480SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ANESTEZİYOLOJİ ANABİLİM DALISAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALIGAZİANTEP CENGİZ GÖKÇEK KADIN SAĞLIĞI VE ÇOCUK HASTALIKLARI HASTANESİHİTİT ÜNİVERSİTESİ, TIP FAKÜLTESİHAKKARİ DEVLET HASTANESİSAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALISAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ANESTEZİYOLOJİ ANABİLİM DALISAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALISAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALIAim: 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.https://dergipark.org.tr/tr/download/article-file/1840536cardiac surgeryheparin titrationtranexamic acidblood transfusion,drainage,kalp cerrahisitraneksamik asitheparin titrasyonudrenaj,kan transfüzyonu, |
| spellingShingle | Aslıhan Aykut Bahadır Aytekin Başak Soran Türkcan Ertekin Utku Ünal Erman Kiriş Bekir Akkaya Z.aslı Demir Ayşen Aksöyek Levent Bırıncıoğlu Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study Acta Medica Alanya cardiac surgery heparin titration tranexamic acid blood transfusion, drainage, kalp cerrahisi traneksamik asit heparin titrasyonu drenaj, kan transfüzyonu, |
| title | Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study |
| title_full | Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study |
| title_fullStr | Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study |
| title_full_unstemmed | Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study |
| title_short | Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study |
| title_sort | heparin titration protocol with tranexamic acid in cardiac surgery a pilot study |
| topic | cardiac surgery heparin titration tranexamic acid blood transfusion, drainage, kalp cerrahisi traneksamik asit heparin titrasyonu drenaj, kan transfüzyonu, |
| url | https://dergipark.org.tr/tr/download/article-file/1840536 |
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