RESUMEN
BACKGROUND: Warfarin has a narrow therapeutic window. Maintaining the patient's international normalized ratio (INR) within a predefined therapeutic range is one of the main challenges of warfarin treatment. This study aimed to compare the INR values of patients followed by face-to-face and telephone applications. METHODS: This study was designed as a randomized controlled trial. Twelve patients living in a distant place were assigned to the experimental group, and 12 patients living nearby and followed-up in the outpatient clinic were assigned to the control group. A Patient Information Form and the Adherence to Refills and Medications Scale were used to collect data. RESULTS: There was no significant difference between the groups in terms of demographic and clinical characteristics except for age (P > .05). The INR values of 67% of the patients followed in the outpatient clinic and 72% of the patients followed with the application were in the therapeutic range. There was no significant difference between the groups and medication adherence was high in both groups (P > .05). CONCLUSION: In light of the findings of our study, which demonstrated that the INR levels of patients who were monitored both face-to-face and via a telephone application were within the same therapeutic range, it was concluded that the telephone application can be used to manage warfarin therapy.
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Aplicaciones Móviles , Humanos , Relación Normalizada Internacional , Warfarina/uso terapéutico , Instituciones de Atención Ambulatoria , TeléfonoRESUMEN
OBJECTIVE: To compare immediate postoperative results in patients receiving heparin-albumin-coated and non-coated circuits. METHODS: A total of 241 patients undergoing on-pump cardiac surgery were divided into two groups: those receiving heparin-coated circuits (Bioline®, Maquet Cardiopulmonary AG., Hirrlingen, Germany) and those receiving non-coated circuits (Maquet Cardiopulmonary AG., Hirrlingen, Germany). RESULTS: Activated clotting times (ACT) during cardiopulmonary bypass (CPB) were significantly shorter in the heparin-albumin-coated group than in the non-coated group (355.64±34.12 vs. 560.38±90.20, respectively, P=0.001). In-hospital mortality and postoperative stroke rates and lengths of intensive care unit stay were similar between the groups; in contrast, in the heparin-albumin-coated group, patients had significantly better outcomes for hospital stay, drainage, and need for erythrocyte transfusion. CONCLUSION: Heparin-coated circuits and reduced level of systemic heparinization with 300 seconds of target ACT level in cardiac surgery under CPB are safe and result in a very satisfactory clinical course.
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Procedimientos Quirúrgicos Cardíacos , Heparina , Puente Cardiopulmonar , Drenaje , Humanos , Tiempo de Internación , MasculinoRESUMEN
Abstract Objective: To compare immediate postoperative results in patients receiving heparin-albumin-coated and non-coated circuits. Methods: A total of 241 patients undergoing on-pump cardiac surgery were divided into two groups: those receiving heparin-coated circuits (Bioline®, Maquet Cardiopulmonary AG., Hirrlingen, Germany) and those receiving non-coated circuits (Maquet Cardiopulmonary AG., Hirrlingen, Germany). Results: Activated clotting times (ACT) during cardiopulmonary bypass (CPB) were significantly shorter in the heparin-albumin-coated group than in the non-coated group (355.64±34.12 vs. 560.38±90.20, respectively, P=0.001). In-hospital mortality and postoperative stroke rates and lengths of intensive care unit stay were similar between the groups; in contrast, in the heparin-albumin-coated group, patients had significantly better outcomes for hospital stay, drainage, and need for erythrocyte transfusion. Conclusion: Heparin-coated circuits and reduced level of systemic heparinization with 300 seconds of target ACT level in cardiac surgery under CPB are safe and result in a very satisfactory clinical course.