Anticoagulation Management and Heparin Resistance During Cardiopulmonary Bypass: A Survey of Society of Cardiovascular Anesthesiologists Members. (August 2019)

• Record Type: Journal Article
• Authors: Sniecinski, Roman M.; Bennett-Guerrero, Elliott; Shore-Lesserson, Linda
• Is Part Of: Anesthesia & analgesia. Volume 129:Number 2(2019)
• Publication Date: 2019-08
• Subjects: Anesthesiology -- Periodicals; Anesthesia; Anesthesiology; Analgesia; Analgesics; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1213/ANE.0000000000003981
• Languages: English
• ISSNs: 0003-2999

Abstract

Abstract : 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.