[Adherence to and Issues on our Institutional Guidelines on Heparin Administration after Withdrawal of Warfarin before Elective Surgery].
Masui
; 66(4): 456-462, 2017 Apr.
Article
em Ja
| MEDLINE
| ID: mdl-30382652
ABSTRACT
BACKGROUND:
We established local guidelines of heparin bridging therapy. However, it is unknown how adherence to our guidelines was achieved and whether our guidelines improved adherence compared with other universal guidelines.METHODS:
A retrospective chart review was con- ducted on compliance with 3 recommendations in the guidelines; these are initial unfractioned heparin dose, timing of unfractioned heparin administration, and two times measurements of activated partial thromboplas- tin time (APTT). We compared 3 recommendations in the guidelines with platelet monitoring which is not described in the guidelines. We also investigated bleed- ing and thromboembolic events during heparin bridg- ing therapy according to the guidelines.RESULTS:
Initial unfractioned heparin dose, timing of unfractioned heparin administration, measurements of APTT, and platelet monitoring were concordant with the guidelines in 78.9%, 19.7%, 67.6%, and 46.5%, respectively. Bleeding events occurred in 3 cases, but no thromboembolic events occurred. Adherence to rec- ommendations for timing of unfractioned heparin administration was the lowest and significantly lower than platelet monitoring.CONCLUSIONS:
Our local guidelines were partially effective to improve adherence We have to alert phy- sicians to care bleeding complications during heparin bridging therapy in our hospital.
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Base de dados:
MEDLINE
Assunto principal:
Heparina
/
Procedimentos Cirúrgicos Eletivos
/
Anticoagulantes
Tipo de estudo:
Etiology_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Ja
Revista:
Masui
Ano de publicação:
2017
Tipo de documento:
Article