Author:
Hikino Keiko,Koido Masaru,Ide Kentaro,Nishimura Nao,Terao Chikashi,Mushiroda Taisei,Nakagawa Satoshi
Abstract
Abstract
We aimed to identify attributing factors to the interindividual variabilities of the infusion rates in unfractionated heparin therapy. We included patients who required unfractionated heparin therapy to achieve the target APTT after cardiac surgery between May 2014 and February 2018. Fifty-nine patients were included, of whom 8 underwent Blalock-Taussig shunt; 27, Glenn procedure; 19, Fontan procedure; 3, mechanical valve replacement; and 2, Rastelli procedure. Previously reported variables that influenced the response to unfractionated heparin treatment were initially compared, which included age; weight; sex; type of surgery; platelet count; fibrinogen, antithrombin III, total protein, albumin, alanine transaminase, and creatinine levels; and use of fresh frozen plasma. The type of surgical procedure was found to be significantly associated with the differences in heparin infusion rate (P = 0.00073). Subsequently, the variance explained by these factors was estimated through a selection based on the minimum Akaike information criterion value; models constructed by various combinations of the surgery types were compared. The model including the Blalock-Taussig shunt, Glenn procedure, and mechanical valve replacement showed the highest summed variance explained (29.1%). More than 70% of the interindividual variability in initial heparin maintenance dosing was unexplained.
Publisher
Springer Science and Business Media LLC
Reference44 articles.
1. Liveris, A. et al. Anti-factor Xa assay is a superior correlate of heparin dose than activated partial thromboplastin time or activated clotting time in pediatric extracorporeal membrane oxygenation. Pediatr. Crit. Care Med. 15, e72–e79 (2014).
2. McLaughlin, K. et al. Evaluation of antifactor-Xa heparin assay and activated partial thromboplastin time values in patients on therapeutic continuous infusion unfractionated heparin therapy. Clin. Appl. Thromb. Hemost. 25, 1076029619876030 (2019).
3. Saini, S. et al. Anti-factor Xa-based monitoring of unfractionated heparin: clinical outcomes in a pediatric cohort. J. Pediatr. 209, 212–219 (2019).
4. Wahking, R. A., Hargreaves, R. H., Lockwood, S. M., Haskell, S. K. & Davis, K. W. Comparing anti-factor Xa and activated partial thromboplastin levels for monitoring unfractionated heparin. Ann. Pharmacother. 53, 801–805 (2019).
5. Olson, J. D. et al. College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy: laboratory monitoring of unfractionated heparin therapy. Arch. Pathol. Lab. Med. 122, 782–798 (1998).
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献