Issue |
J Extra Corpor Technol
Volume 36, Number 2, June 2004
|
|
---|---|---|
Page(s) | 139 - 144 | |
DOI | https://doi.org/10.1051/ject/2004362139 | |
Published online | 08 August 2023 |
Comparison of Heparin Administration Using the Rapidpoint™ Coag and Hepcon® HMS
1
Charleston Area Medical Center, Charleston, West Virginia
2
CAMC Health Education and Research Institute, Charleston, West Virginia
* Address correspondence to: ason Newsome, MLT, Charleston Area Medical Center, 3200 MacCorkle Avenue SE, Charleston, WV 25304. E-mail: jason.newsome@camc.org
A retrospective chart review was conducted of patients who underwent cardiopulmonary bypass (CPB) to compare the quantities of heparin administered, postoperative blood loss, and homologous blood products transfused during their procedure and subsequent stay in the intensive care unit. The primary purpose of this review was to determine if any difference in heparin administration resulted when two different devices were used for dosing and monitoring heparin. Postoperative blood loss and amount of blood products transfused were also quantified, as any differences would potentially be a result of a difference in administration of heparin. The first group (n = 341) underwent CPB using the Hepcon® HMS, Medtronic Inc., Minneapolis, MN, for heparin dosing and monitoring. The Rapid Point™ Coag, Bayer Healthcare LLC, Tarrytown, NY was used for the second group (n = 345). The two populations were compared for similarity on: age, body surface area (BSA), CPB time (minutes), aortic-cross clamp time (minutes), baseline activated clotting time, and baseline hematocrit. No significant difference was found between the two groups. The second group, using the Rapidpoint™ Coag, received less heparin during CPB than the group using the Hepcon® HMS. In addition, there were decreases in amounts of some blood products transfused as well as mediastinal drainage from the Hepcon® HMS to the Rapidpoint™ Coag group. A summary of the findings can be found in Table 1. A secondary purpose of this study was to determine the influence of hemodilution on the Heparin Management Test (HMT®). Citrated whole blood was diluted to varying degrees at various concentrations to determine whether hemodilution with crystalloid would alter the HMT® measurements. At all heparin levels and degrees of dilution, the HMT® remained stable, with coefficients of variation (CV) of less than 5% at all heparin levels even while incorporating excessive crystalloid dilution (up to 75%).
Key words: cardiopulmonary bypass / activated clotting time / heparin-protamine titration / mediastinal drainage / homologous blood products
© 2004 AMSECT
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