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Journals / Acta Medica Alanya / 2021 / Cilt: 5 Sayı: 3

Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study

Kalp Cerrahisinde Traneksamik Asit ile Beraber Heparin Titrasyon Protokolü Kullanımına Yönelik Bir Pilot Çalışma

Başak Soran Türkcan(GAZİANTEP CENGİZ GÖKÇEK KADIN SAĞLIĞI VE ÇOCUK HASTALIKLARI HASTANESİ)0000-0002-0694-5211
Ertekin Utku Ünal(HİTİT ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-1144-8906
Erman Kiriş(HAKKARİ DEVLET HASTANESİ)0000-0002-8550-0922
Bahadır Aytekin(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI)0000-0003-4275-0072
Bekir Akkaya(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI)0000-0002-3167-8434
Z.aslı Demir(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ANESTEZİYOLOJİ ANABİLİM DALI)0000-0003-3053-0443
Aslıhan Aykut(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ANESTEZİYOLOJİ ANABİLİM DALI)0000-0003-0382-3494
Ayşen Aksöyek(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI)0000-0001-7306-0459
Levent Bırıncıoğlu(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI)0000-0002-4660-1480
Pages
282–288
Publication Date
2021-12-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The aim of this pilot study was to assess the effect of a newly adapted blood conservation strategy, including heparin titration protocol along with antifibrinolytics, regarding to mediastinal bleeding, re-exploration for bleeding and blood and blood products utilization.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Postoperative bleeding related to cardiac surgery is a clinically important condition.
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Key Findings & Data:Consequently, re-exploration and increased blood utilization lead to adverse outcomes.
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Conclusion & Impact:The aim of this pilot study was to assess the effect of a newly adapted blood conservation strategy, including heparin titration protocol along with antifibrinolytics, regarding to mediastinal bleeding, re-exploration for bleeding and blood and blood products utilization.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:kalp cerrahisi · traneksamik asit · heparin titrasyonu

Abstract

Aim: Postoperative bleeding related to cardiac surgery is a clinically important condition. Consequently, re-exploration and increased blood utilization lead to adverse outcomes. The aim of this pilot study was to assess the effect of a newly adapted blood conservation strategy, including heparin titration protocol along with antifibrinolytics, regarding to mediastinal bleeding, re-exploration for bleeding and blood and blood products utilization.

Özet

Amaç: Kalp cerrahisi ile ilişkili postoperatif kanama klinik olarak önemli bir durumdur. Sonuç olarak, reeksplorasyon ve artan kan kullanımı olumsuz sonuçlara yol açar. Bu pilot çalışmanın amacı, mediastinal kanama, kanama sebepli reeksplorasyon ve kan-kan ürünü kullanımına ilişkin antifibrinolitikler ile birlikte heparin titrasyon protokolünü içeren yeni uyarlanmış bir kan koruma stratejisinin etkisini değerlendirmektir. Yöntemler: Bu çalışmaya Ocak 2015 ile Ağustos 2016 tarihleri arasında mitral kapak replasmanı, aort kapak replasmanı, asendan/arkus aort cerrahisi gibi kanama riski daha yüksek kalp cerrahisi geçiren 100 hasta dahil edilmiştir. Çalışma grubu yeni protokol uygulanan ardışık hastalardan oluşmaktadır.(heparin titrasyon protokolü+traneksamik asit) Kontrol grubu ise standart doz heparin (4 mg/kg) uygulanan hastalardan oluşmaktadır.Her gruptaki 50 hasta (yeni protokol ve standart protokol) uygulanan heparin miktarı, kan-kan ürünü kullanımı, mediastinal drenaj ve reeksplorasyon açısından karşılaştırıldı. Bulgular: Çalışma grubundaki 50 hastanın 28’i (%56) ilk 24 saat boyunca kırmızı kan hücresi (RBC) transfüzyonu aldı. 3 üniteden fazla RBC transfüzyonu alan hasta sayısı çalışma grubunda daha düşüktü. (%34’e karşı %54; p=0.044). Ayrıca reeksplorasyon oranları benzer olarak bulundu. Sonuç: Sonuç olarak, çalışma sonuçlarımıza göre önerilen heparin titrasyon protokolünün postoperative kanama ve kan ürünü kullanımını azaltmada faydalı olduğu görülmektedir. Kalp cerrahisinde kan transfüzyonu ihtiyacını azaltmak için heparin titrasyon protokolü gibi kan kullanım protokollerinin oluşturulması gerektiğini düşünüyoruz.

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Cite This Article

Türkcan, B. S., Ünal, E. U., Kiriş, E., Aytekin, B., Akkaya, B., Demir, Z., Aykut, A., Aksöyek, A., Bırıncıoğlu, L. (2021). Heparin titration protocol with tranexamic acid in cardiac surgery: a pilot study. Acta Medica Alanya, Cilt: 5 Sayı: 3, 282–288. https://doi.org/10.30565/medalanya.956769

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