Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Intraoperative anticoagulation in cardiovascular surgery

D J Effeney, J Goldstone, D Chin

    Surgery
    |December 1, 1981
    PubMed
    Summary

    Heparin dosing for surgery is unpredictable. Individual patient responses vary, making standard doses unreliable for preventing thrombosis or bleeding during cardiovascular operations. Intraoperative monitoring is essential for consistent heparin effect.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Oral health and related outcomes in children and adolescents with cystic fibrosis: a scoping review.

    European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry·2024
    Same author

    Remote wireless vital signs monitoring on the ward for early detection of deteriorating patients: A case series.

    International journal of nursing studies·2020
    Same author

    Mating strategies to maximize genetic merit in dairy cattle herds.

    Journal of dairy science·2018
    Same author

    Emergence of Zika Virus Epidemic and the National Response in Jamaica.

    The West Indian medical journal·2017
    Same author

    Anti-leukemic activity and tolerability of anti-human CD47 monoclonal antibodies.

    Blood cancer journal·2017
    Same author

    A rare association between constrictive pericarditis and congenital ichthyosis.

    Clinical and experimental dermatology·2016

    Area of Science:

    • Cardiovascular Surgery
    • Anesthesiology
    • Pharmacokinetics

    Background:

    • Determining optimal heparin dosage for preventing intraoperative thrombosis and bleeding during cardiovascular operations remains a challenge.
    • Significant variability exists in patient responses to heparin, impacting its anticoagulant efficacy.

    Purpose of the Study:

    • To investigate the pharmacokinetics and variability of heparin's anticoagulant effect in patients undergoing cardiovascular and peripheral vascular operations.
    • To assess the predictability of heparin's effect based on dosage and patient type.

    Main Methods:

    • Measured activated clotting time (ACT) in 28 patients undergoing peripheral vascular and cardiac operations using an electronic clot timer.
    • Determined maximum ACT, time to maximum ACT, and heparin effect half-time (t1/2) after initial heparin administration.

    Related Experiment Videos

  • Compared heparin kinetics between cardiac and peripheral vascular surgery patients.

    • Main Results:

    • Heparin's anticoagulant effect and duration (t1/2) varied significantly among patients, independent of administered dose.
    • Maximum heparin effect occurred later than previously assumed and differed between cardiac and vascular procedures.
    • No significant difference in t1/2 was observed between cardiac and vascular patients despite dose variations.
    • Intraoperative heparin effect showed a longer t1/2 compared to preoperative administration in a subset of patients.

    Conclusions:

    • Standard heparin dosing is unpredictable in both maximum effect and duration, challenging its use for consistent intraoperative anticoagulation.
    • Current recommendations for adjusting heparin based on early ACT measurements are not supported by these findings.
    • Intraoperative monitoring of heparin effect is crucial for achieving a consistent and specific anticoagulant level, tailored to individual patient needs.