Agreements between the prothrombin times of blood treated in vitro with heparinase during cardiopulmonary bypass (CPB) and blood sampled after CPB and systemic protamine
Publication in refereed journal


摘要The prothrombin time (PT) is useful for identifying coagulation factor deficits after cardiopulmonary bypass (CPB). However, long processing times and the need for fresh frozen plasma (FFP) to be thawed cause delays in factor replacement. We hypothesized that, by treating with heparinase, blood sampled toward the end of CPB can provide PT results that help to determine the requirement for FFP after CPB. Laboratory delays can be eliminated with point-of-care monitors. We studied 158 adults undergoing non-emergent cardiac surgery. Blood taken before separation from CPB was mixed with heparinase, and PT was measured in the laboratory with a HemoTec timer. Agreements between these results and laboratory measurements of blood taken after systemic protamine were compared by using Bland and Altman plots with the threshold of +/-1.0 s. We found that the laboratory PT measurements during CPB versus after CPB were comparable, but the limits of agreement exceeded these thresholds. Similarly, there was unsatisfactory agreement between the HemoTec and laboratory PT results measured before, during, and after CPB. For each PT measured during CPB, the corresponding confidence interval for the postprotamine PT was calculated. During CPB, a laboratory PT of less than or equal to16 s or greater than or equal to18 s suggests a greater than or equal to83% or greater than or equal to93% probability of not requiring or potentially requiring, respectively, FFP after CPB. We conclude that the majority of PT measurements obtained from blood taken before weaning from CPB and treated in vitro with heparinase was associated with a high probability of whether or not FFP would be needed after CPB.
著者Ho AMH, Lee A, Ling E, Daly A, Teoh K, Warkentin TE
會議名稱58th Annual Meeting of the Canadian-Anesthesiologists-Society
期刊名稱Anesthesia and Analgesia
出版社Lippincott, Williams & Wilkins
頁次15 - 20
Web of Science 學科類別Anesthesiology

上次更新時間 2020-21-11 於 01:22