Heparin sensitivity and postoperative blood loss

Heparin sensitivity and postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass: BACKGROUND

Heparin-associated coagulation disorder is an important factor related to postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass. Currently, the relationship between heparin sensitivity and postoperative bleeding is unknown.

OBJECTIVE

To investigate the relationship between individual heparin sensitivity and postoperative blood loss in patients undergoing cardiac surgery.

DESIGN

Prospective controlled study.

SETTING

Tertiary teaching hospital, Urumqi, Xinjiang, PR China. The study was conducted from January 2016 to August 2018.

PATIENTS

A total of 195 adult patients undergoing cardiac valve replacement surgery were included.

INTERVENTION

After initial heparin dosing (2.5 mg kg−1), patients were divided into three groups according to the whole blood activated clotting time (ACT): group A, insensitive group (ACT  750 s).

MAIN OUTCOME MEASURES

First, intra-operative and 24-h postoperative blood loss. Second, antithrombin (AT) and factor X mRNA levels. Third, the plasma levels of AT-III and factor X. Fourth, heparin sensitivity index.

RESULTS

Blood loss was approximately 20 to 25% lower in group B than in groups A and C, which was statistically significant (P