Is There a "Blind Spot" in Point-of-Care Testing for Residual Heparin After Cardiopulmonary Bypass? A Prospective, Observational Cohort Study.
Clin Appl Thromb Hemost
; 26: 1076029620946843, 2020.
Article
de En
| MEDLINE
| ID: mdl-32795187
ABSTRACT
Identifying the cause of a bleeding complication after cardiac surgery can be crucial. This study sought to clarify whether the application of unprocessed autologous pump blood influences anti-factor Xa activity after cardiac surgery and evaluated 2 point-of-care methods regarding their ability to identify an elevated anti-factor Xa activity at different timepoints after cardiopulmonary bypass. Anti-factor Xa activity, heparin/protamine titration and the clotting time ratio of thromboelastometry in the INTEM and HEPTEM were measured at baseline (T1), after the application of protamine (T2) and after the complete application of autologous pump blood (T3). Anti-factor Xa activity decreased significantly between T2 and T3 as well did the absolute number of patients with an elevated anti-factor Xa activity. Receiver Operating Curve analyses were performed for both point-of-care methods. At T2 neither could identify patients with an elevated anti-factor Xa activity, while both methods were able to do so at T3 with high sensitivity and specificity. This difference suggests that an interference in the detection of residual heparinization with point-of-care methods exists right after the application of protamine, which seems to subside after a short time span. Nevertheless, results of point-of-care testing for residual heparinization after cardiopulmonary bypass need to be interpreted considering the protamine-heparin ratio and the timepoint of protamine administration.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Héparine
/
Pontage cardiopulmonaire
/
Analyse sur le lieu d'intervention
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limites:
Aged
/
Female
/
Humans
/
Male
Langue:
En
Journal:
Clin Appl Thromb Hemost
Sujet du journal:
ANGIOLOGIA
Année:
2020
Type de document:
Article
Pays d'affiliation:
Allemagne