PMID- 38367099
OWN - NLM
STAT- Publisher
LR  - 20240217
IS  - 1619-0904 (Electronic)
IS  - 1434-7229 (Linking)
DP  - 2024 Feb 17
TI  - Contributing factors to heparin resistance during cardiopulmonary bypass.
LID - 10.1007/s10047-024-01435-1 [doi]
AB  - Since the risk factors for heparin resistance (HR) before cardiopulmonary bypass 
      (CPB) have not been fully clarified, this study investigated the contributing 
      factors for HR after the initial unfractionated heparin (UFH) dose of 500 IU/kg. 
      We retrospectively analyzed the data of 371 patients who underwent CPB surgery, 
      with the initial UFH dose of 500 IU/kg, between May 2017 and December 2021. We 
      defined HR as the failure to achieve activated clotting time (ACT) of > 480 s 
      after the initial UFH dose of 500 IU/kg. HR was observed in 36 patients (9.7%) 
      (HR group), while HR was not observed in 335 patients (control group). The HR 
      group included significantly more patients with preoperative use of UFH, with 
      significantly higher white blood cell counts, fibrinogen, fibrinogen degradation 
      products, D-dimer, and C-reactive protein, and lower hemoglobin and albumin. The 
      multivariable logistic regression analysis identified albumin (OR: 3.09, 95% CI 
      1.3504-7.0845, p = 0.0075) and fibrinogen (OR: 0.99, 95% CI 0.9869-0.9963, 
      p = 0.0003) as independent predictors for HR. Using the Youden index, the cutoffs 
      of albumin and fibrinogen were calculated as 3.8 g/dL and 303 mg/dL, 
      respectively. The receiver operating characteristic curves showed the predictive 
      performance of albumin (area under the curve (AUC): 0.78, sensitivity: 65%, 
      specificity: 81%) and fibrinogen (AUC: 0.77, sensitivity: 56%, specificity: 88%). 
      The incidence of HR after the initial UFH dose of 500 IU/kg was 9.7%. The 
      preoperative albumin < 3.8 g/dL and fibrinogen > 303 mg/dL were independent 
      predictors for HR.
CI  - (c) 2024. The Japanese Society for Artificial Organs.
FAU - Yamashiro, Tomoaki
AU  - Yamashiro T
AD  - Department of Clinical Engineering, Fujita Health University Hospital, 1-98 
      Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. tyama@fujita-hu.ac.jp.
FAU - Takami, Yoshiyuki
AU  - Takami Y
AUID- ORCID: 0000-0002-4623-6233
AD  - Department of Cardiovascular Surgery, Fujita Health University School of 
      Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. 
      mytakami@fujita-hu.ac.jp.
FAU - Takagi, Yasushi
AU  - Takagi Y
AD  - Department of Cardiovascular Surgery, Fujita Health University School of 
      Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
LA  - eng
PT  - Journal Article
DEP - 20240217
PL  - Japan
TA  - J Artif Organs
JT  - Journal of artificial organs : the official journal of the Japanese Society for 
      Artificial Organs
JID - 9815648
SB  - IM
OTO - NOTNLM
OT  - Activated clotting time
OT  - Cardiopulmonary bypass
OT  - Heparin resistance
OT  - Unfractionated heparin
EDAT- 2024/02/17 21:42
MHDA- 2024/02/17 21:42
CRDT- 2024/02/17 11:06
PHST- 2023/12/02 00:00 [received]
PHST- 2024/01/18 00:00 [accepted]
PHST- 2024/02/17 21:42 [medline]
PHST- 2024/02/17 21:42 [pubmed]
PHST- 2024/02/17 11:06 [entrez]
AID - 10.1007/s10047-024-01435-1 [pii]
AID - 10.1007/s10047-024-01435-1 [doi]
PST - aheadofprint
SO  - J Artif Organs. 2024 Feb 17. doi: 10.1007/s10047-024-01435-1.