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Individual variation in unfractionated heparin dosing after pediatric cardiac surgery
- Source :
- Scientific Reports, Vol 10, Iss 1, Pp 1-9 (2020), Scientific Reports
- Publication Year :
- 2020
- Publisher :
- Nature Publishing Group, 2020.
-
Abstract
- We aimed to identify attributing factors to the interindividual variabilities of the infusion rates in unfractionated heparin therapy. We included patients who required unfractionated heparin therapy to achieve the target APTT after cardiac surgery between May 2014 and February 2018. Fifty-nine patients were included, of whom 8 underwent Blalock-Taussig shunt; 27, Glenn procedure; 19, Fontan procedure; 3, mechanical valve replacement; and 2, Rastelli procedure. Previously reported variables that influenced the response to unfractionated heparin treatment were initially compared, which included age; weight; sex; type of surgery; platelet count; fibrinogen, antithrombin III, total protein, albumin, alanine transaminase, and creatinine levels; and use of fresh frozen plasma. The type of surgical procedure was found to be significantly associated with the differences in heparin infusion rate (P = 0.00073). Subsequently, the variance explained by these factors was estimated through a selection based on the minimum Akaike information criterion value; models constructed by various combinations of the surgery types were compared. The model including the Blalock-Taussig shunt, Glenn procedure, and mechanical valve replacement showed the highest summed variance explained (29.1%). More than 70% of the interindividual variability in initial heparin maintenance dosing was unexplained.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
lcsh:Medicine
030204 cardiovascular system & hematology
Paediatric research
Fontan Procedure
Article
Thromboplastin
Fontan procedure
03 medical and health sciences
0302 clinical medicine
Medical research
medicine
Humans
030212 general & internal medicine
Cardiac Surgical Procedures
lcsh:Science
Blalock-Taussig Procedure
Multidisciplinary
biology
business.industry
Heparin
Antithrombin
lcsh:R
Anticoagulants
Infant
Rastelli procedure
Cardiac surgery
Alanine transaminase
Glenn procedure
Anesthesia
Child, Preschool
biology.protein
Female
lcsh:Q
Fresh frozen plasma
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20452322
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Scientific Reports
- Accession number :
- edsair.doi.dedup.....04913fa93ac61f98318c567d691b669e