Key result
Monitoring anticoagulant therapy with activated whole blood clotting time significantly reduced postoperative blood loss from 1.12 to 0.70 ml/kg/h in children undergoing open-heart surgery.
Why the study?
Does monitoring anticoagulant therapy using activated whole blood clotting time reduce postoperative blood loss in pediatric patients subjected to cardiopulmonary bypass for congenital heart disease surgery?
Observational
Does monitoring anticoagulant therapy using activated whole blood clotting time reduce postoperative blood loss in pediatric patients subjected to cardiopulmonary bypass for congenital heart disease surgery?
Effect estimate: 30% reduction
Absolute Event Rate: 0.7% vs 1.12%
Using activated whole blood clotting time to monitor anticoagulant therapy during pediatric congenital heart surgery reduces postoperative blood loss but does not change the incidence of significant hemorrhage.
May support point-of-care monitoring in pediatric cardiac surgery; hypothesis-generating and requires randomized confirmation before practice change.
A significant reduction (30%) in the amount of postoperative blood loss from 1.12 to 0.70 ml/kg/h was noted in pediatric patients subjected to cardiopulmonary bypass for congenital heart disease surgery when the activated whole blood clotting time was utilized to monitor anticoagulant therapy. However, no difference in the incidence (11%) of postoperative hemorrhage was noted. Extensive preoperative laboratory hemostasis testing and routine immediate postoperative use of platelet transfusion and fresh frozen plasma (in cyanotic heart defects) failed to predict or correct those patients with significant postoperative hemorrhage.
No takes yet. Share an insight, caveat, or question.
Juméan et al. (2009) conducted an observational in Congenital heart disease. Activated whole blood clotting time monitoring was evaluated on Postoperative blood loss (ml/kg/h) (30% reduction). Monitoring anticoagulant therapy with activated whole blood clotting time significantly reduced postoperative blood loss from 1.12 to 0.70 ml/kg/h in children undergoing open-heart surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: