Real time measurement of heparin concentration during cardiopulmonary bypass

Kazuhiro Hashimoto, T. Sasaki, T. Hachiya, H. Takakura, K. Onoguchi, R. Nagahori, S. Takeuchi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. A heparin/protamine titration system for measurement of heparin levels (Hepcon) is promising for efficient anticoagulation during cardiopulmonary bypass (CPB). Methods. Fifty-seven patients subjected to CPB were divided into two groups, control (n = 24) and Hepcon groups (n = 33). The Hepcon group was further divided into three subgroups according to perfusion temperature. For the control group, conventional administration of an anticoagulant (300 IU/kg of heparin) and reversal protocol (heparin 1: protamine 1) was performed. For the Hepcon group, a heparin dose-response assay directed the initial dose of heparin. Hepcon also determined the dose of protamine by the titration. The initial dose of heparin in the control group (300 IU/kg) was statistically less than that of Hepcon group (360 ± 80 IU/kg). Results. In the Hepcon group, the sensitivity to heparin was correlated with coagulation time (r = -0.78) and antithrombin III levels (r = 0.70), and individual difference of sensitivity resulted in a wide range of dosage (160 to 490 IU/kg). A strong correlation was observed between plasma and whole blood concentration of heparin (r = 0.86). However, they did not correlate with ACT values. Perfusion temperature didn't affect the heparin level, but did the ACT value. In the Hepcon group, the dose of protamine was significantly less and adverse events were rare. Conclusions. In conclusion, whole blood heparin measurements correlated well with plasma heparin concentration. Protamine titration of heparin reduced the dose of protamine and decreased the chance of adverse reactions.

Original languageEnglish
Pages (from-to)645-651
Number of pages7
JournalJournal of Cardiovascular Surgery
Volume40
Issue number5
Publication statusPublished - 1999 Oct

Fingerprint

Cardiopulmonary Bypass
Heparin
Protamines
Control Groups
Perfusion
Temperature
Antithrombin III
Hepcon
Individuality
Anticoagulants

Keywords

  • Cardiopulmonary bypass
  • Heparin
  • Protamines

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hashimoto, K., Sasaki, T., Hachiya, T., Takakura, H., Onoguchi, K., Nagahori, R., & Takeuchi, S. (1999). Real time measurement of heparin concentration during cardiopulmonary bypass. Journal of Cardiovascular Surgery, 40(5), 645-651.

Real time measurement of heparin concentration during cardiopulmonary bypass. / Hashimoto, Kazuhiro; Sasaki, T.; Hachiya, T.; Takakura, H.; Onoguchi, K.; Nagahori, R.; Takeuchi, S.

In: Journal of Cardiovascular Surgery, Vol. 40, No. 5, 10.1999, p. 645-651.

Research output: Contribution to journalArticle

Hashimoto, K, Sasaki, T, Hachiya, T, Takakura, H, Onoguchi, K, Nagahori, R & Takeuchi, S 1999, 'Real time measurement of heparin concentration during cardiopulmonary bypass', Journal of Cardiovascular Surgery, vol. 40, no. 5, pp. 645-651.
Hashimoto K, Sasaki T, Hachiya T, Takakura H, Onoguchi K, Nagahori R et al. Real time measurement of heparin concentration during cardiopulmonary bypass. Journal of Cardiovascular Surgery. 1999 Oct;40(5):645-651.
Hashimoto, Kazuhiro ; Sasaki, T. ; Hachiya, T. ; Takakura, H. ; Onoguchi, K. ; Nagahori, R. ; Takeuchi, S. / Real time measurement of heparin concentration during cardiopulmonary bypass. In: Journal of Cardiovascular Surgery. 1999 ; Vol. 40, No. 5. pp. 645-651.
@article{c8c81be5c53e47f9aa1cc1decf38fc4c,
title = "Real time measurement of heparin concentration during cardiopulmonary bypass",
abstract = "Background. A heparin/protamine titration system for measurement of heparin levels (Hepcon) is promising for efficient anticoagulation during cardiopulmonary bypass (CPB). Methods. Fifty-seven patients subjected to CPB were divided into two groups, control (n = 24) and Hepcon groups (n = 33). The Hepcon group was further divided into three subgroups according to perfusion temperature. For the control group, conventional administration of an anticoagulant (300 IU/kg of heparin) and reversal protocol (heparin 1: protamine 1) was performed. For the Hepcon group, a heparin dose-response assay directed the initial dose of heparin. Hepcon also determined the dose of protamine by the titration. The initial dose of heparin in the control group (300 IU/kg) was statistically less than that of Hepcon group (360 ± 80 IU/kg). Results. In the Hepcon group, the sensitivity to heparin was correlated with coagulation time (r = -0.78) and antithrombin III levels (r = 0.70), and individual difference of sensitivity resulted in a wide range of dosage (160 to 490 IU/kg). A strong correlation was observed between plasma and whole blood concentration of heparin (r = 0.86). However, they did not correlate with ACT values. Perfusion temperature didn't affect the heparin level, but did the ACT value. In the Hepcon group, the dose of protamine was significantly less and adverse events were rare. Conclusions. In conclusion, whole blood heparin measurements correlated well with plasma heparin concentration. Protamine titration of heparin reduced the dose of protamine and decreased the chance of adverse reactions.",
keywords = "Cardiopulmonary bypass, Heparin, Protamines",
author = "Kazuhiro Hashimoto and T. Sasaki and T. Hachiya and H. Takakura and K. Onoguchi and R. Nagahori and S. Takeuchi",
year = "1999",
month = "10",
language = "English",
volume = "40",
pages = "645--651",
journal = "Journal of Cardiovascular Surgery",
issn = "0021-9509",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "5",

}

TY - JOUR

T1 - Real time measurement of heparin concentration during cardiopulmonary bypass

AU - Hashimoto, Kazuhiro

AU - Sasaki, T.

AU - Hachiya, T.

AU - Takakura, H.

AU - Onoguchi, K.

AU - Nagahori, R.

AU - Takeuchi, S.

PY - 1999/10

Y1 - 1999/10

N2 - Background. A heparin/protamine titration system for measurement of heparin levels (Hepcon) is promising for efficient anticoagulation during cardiopulmonary bypass (CPB). Methods. Fifty-seven patients subjected to CPB were divided into two groups, control (n = 24) and Hepcon groups (n = 33). The Hepcon group was further divided into three subgroups according to perfusion temperature. For the control group, conventional administration of an anticoagulant (300 IU/kg of heparin) and reversal protocol (heparin 1: protamine 1) was performed. For the Hepcon group, a heparin dose-response assay directed the initial dose of heparin. Hepcon also determined the dose of protamine by the titration. The initial dose of heparin in the control group (300 IU/kg) was statistically less than that of Hepcon group (360 ± 80 IU/kg). Results. In the Hepcon group, the sensitivity to heparin was correlated with coagulation time (r = -0.78) and antithrombin III levels (r = 0.70), and individual difference of sensitivity resulted in a wide range of dosage (160 to 490 IU/kg). A strong correlation was observed between plasma and whole blood concentration of heparin (r = 0.86). However, they did not correlate with ACT values. Perfusion temperature didn't affect the heparin level, but did the ACT value. In the Hepcon group, the dose of protamine was significantly less and adverse events were rare. Conclusions. In conclusion, whole blood heparin measurements correlated well with plasma heparin concentration. Protamine titration of heparin reduced the dose of protamine and decreased the chance of adverse reactions.

AB - Background. A heparin/protamine titration system for measurement of heparin levels (Hepcon) is promising for efficient anticoagulation during cardiopulmonary bypass (CPB). Methods. Fifty-seven patients subjected to CPB were divided into two groups, control (n = 24) and Hepcon groups (n = 33). The Hepcon group was further divided into three subgroups according to perfusion temperature. For the control group, conventional administration of an anticoagulant (300 IU/kg of heparin) and reversal protocol (heparin 1: protamine 1) was performed. For the Hepcon group, a heparin dose-response assay directed the initial dose of heparin. Hepcon also determined the dose of protamine by the titration. The initial dose of heparin in the control group (300 IU/kg) was statistically less than that of Hepcon group (360 ± 80 IU/kg). Results. In the Hepcon group, the sensitivity to heparin was correlated with coagulation time (r = -0.78) and antithrombin III levels (r = 0.70), and individual difference of sensitivity resulted in a wide range of dosage (160 to 490 IU/kg). A strong correlation was observed between plasma and whole blood concentration of heparin (r = 0.86). However, they did not correlate with ACT values. Perfusion temperature didn't affect the heparin level, but did the ACT value. In the Hepcon group, the dose of protamine was significantly less and adverse events were rare. Conclusions. In conclusion, whole blood heparin measurements correlated well with plasma heparin concentration. Protamine titration of heparin reduced the dose of protamine and decreased the chance of adverse reactions.

KW - Cardiopulmonary bypass

KW - Heparin

KW - Protamines

UR - http://www.scopus.com/inward/record.url?scp=0032729799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032729799&partnerID=8YFLogxK

M3 - Article

C2 - 10596996

AN - SCOPUS:0032729799

VL - 40

SP - 645

EP - 651

JO - Journal of Cardiovascular Surgery

JF - Journal of Cardiovascular Surgery

SN - 0021-9509

IS - 5

ER -