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Anticoagulation monitoring during extracorporeal circulation with the Hepcon/HMS device

N Noui1, E Zogheib, K Walczak

  • 1Anesthesiology Unit, South Hospital, Amiens, France.

Perfusion
|February 4, 2012
PubMed

Insights

The Hepcon/HMS device improved anticoagulation management during cardiac surgery, reducing bleeding and red blood cell transfusions. This method offers a safer approach to heparin and protamine titration, leading to shorter chest closure times.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Hematology

Background:

  • Standard anticoagulation protocols using unfractionated heparin (UH) require careful management during cardiopulmonary bypass (CPB).
  • Accurate titration of heparin and protamine is crucial to prevent bleeding and thromboembolic complications in cardiac surgery patients.

Purpose of the Study:

  • To compare the efficacy of the standard anticoagulation protocol versus the Hepcon/HMS device for heparin and protamine management.
  • To evaluate the impact of the Hepcon/HMS device on postoperative bleeding, transfusion requirements, and procedural times.

Main Methods:

  • A comparative study involving 44 patients undergoing coronary artery bypass grafting (CABG) or aortic valve replacement (AVR).
  • Patients were divided into two groups: a control group (n=22) receiving standard UH anticoagulation and a Hepcon/HMS group (n=22) where doses were guided by the device.
  • Protamine was used to antagonize heparin in a dose-dependent manner in both groups.

Main Results:

  • The Hepcon/HMS group exhibited significantly shorter chest closure times (42 ± 15 min vs. 68 ± 27 min, p=0.001).
  • Postoperative bleeding was significantly lower in the Hepcon/HMS group (804 ± 729 ml vs. 1416 ± 1103 ml, p=0.016).
  • Red blood cell transfusion requirements were reduced postoperatively in the Hepcon/HMS group (1.04 ± 1.5 units vs. 2.1 ± 1.87 units, p=0.05).

Conclusions:

  • Heparin and protamine titration using the Hepcon/HMS device during CPB can lead to reduced protamine dosage and lower postoperative bleeding.
  • The Hepcon/HMS system may decrease perioperative red blood cell transfusions and shorten chest closure times without increasing thromboembolic events.
Abstract

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