Cardiac Surgery Clinical Trial
Official title:
The Impact of an Adjusted Calculation Model Regarding Heparin and Protamine Dosing on Bleeding and Transfusions After Cardiac Surgery Compared With Standard Dosing: A Randomized Single Blind Trial
The study will compare a novel calculation model (HeProCalc AB) with a standard weight-based and activated clotting time adjusted calculation for the dosing of Heparin and protamine and assess the impact on postoperative bleeding and blood transfusions after cardiac surgery.
During cardiac surgery with cardiopulmonary bypass (CPB), efficient anticoagulation is
required in order to avoid microscopic clot formation or, in worst case, massive lift
threatening thrombus formation. Heparin is by far the most common drug used to prevent blood
from coagulating during CPB. Activated clotting time (ACT) is a point-of-care test of fibrin
clotting time that has to be well prolonged to initiate safe CPB.
Following weaning from CPB, heparin is reversed by protamine. Administration of excess doses
of protamine may have a deleterious effect on coagulation and contribute to postoperative
bleeding with need of blood transfusions. In connection with CPB management, heparin and
protamin doses are commonly calculated using body weight and ACT. However, a new
Heparin-Protamin-Calculation computer program (HeProCalc) has been developed to provide
patient titrated dosing of both heparin and protamin. However, any benefits regarding
postoperative bleeding and transfusions has not been thoroughly investigated.
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