Anticoagulation Management and Heparin Resistance During Cardiopulmonary Bypass: A Survey of Society of Cardiovascular Anesthesiologists Members
Anticoagulation Management and Heparin Resistance During Cardiopulmonary Bypass: A Survey of Society of Cardiovascular Anesthesiologists Members
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DOI：
10.1213/ane.0000000000003981
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发表时间：
2019-08-01
影响因子：
5.7
通讯作者：
Shore-Lesserson, Linda
中科院分区：
文献类型：
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作者：
Sniecinski, Roman M.;Bennett-Guerrero, Elliott;Shore-Lesserson, Linda
我们调查了心血管麻醉师协会成员关于体外循环抗凝实践和对肝素抵抗的态度。在550名应答者（18.5%应答率）中，74.9% （95% CI, 71.3%-78.5%）使用基于体重的肝素剂量，70.7% （95% CI, 66.9%-74.5%）的目标是激活凝血时间为400或480秒启动体外循环。值得注意的是，17.1% （95% CI, 13.9%-20.2%）的受访者报告激活凝血时间目标低于最近的2018年胸外科学会/心血管麻醉学会/美国体外技术学会指南推荐的目标，或者根本没有监测肝素的作用。当遇到肝素耐药时，54.2%的应答者（95% CI, 50.0%-58.4%）将抗凝血酶浓缩液作为一线治疗。
We surveyed Society of Cardiovascular Anesthesiologists members regarding anticoagulation practices for cardiopulmonary bypass and attitudes on heparin resistance. Of 550 respondents (18.5% response rate), 74.9% (95% CI, 71.3%-78.5%) used empiric weight-based dosing of heparin, and 70.7% (95% CI, 66.9%-74.5%) targeted an activated clotting time of either 400 or 480 seconds to initiate cardiopulmonary bypass. Of note, 17.1% (95% CI, 13.9%-20.2%) of respondents reported activated clotting time targets lower than those recommended by recent 2018 Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology guidelines or failed to monitor heparin effects at all. When heparin resistance was encountered, 54.2% of respondents (95% CI, 50.0%-58.4%) administered antithrombin concentrates as a first-line therapy.