초록접수 현황
| 17F-008 | 포스터 발표 |
Risk Factors Associated with Difficult Conversion of Heparin by Protamine during Cardiopulmonary Bypass
Min Jung Ku, Seogjae Lee, Jee Won Chang, Jonggeun Lee, Su Wan Kim
Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
Purpose : Prolonged activated clotting time (ACT) during weaning from cardiopulmonary bypass (CPB) is difficult to be normalized by protamine infusion, and then it needs to add protamine. We aimed to analyze the risk factors associated with difficult conversion of heparin by protamine during CPB.
Methods : Between June 2009 and June 2017, 120 consecutive patients underwent open heart surgery or aortic surgery requiring CPB. The patients were classified into the patients with completely conversed ACT by single infusion of protamine (group A, n = 89) and the patients with difficultly conversed ACT requiring addition of protamine infusion one more time (group B, n = 31).
Results : There was no statistical difference in the ICU stay, in-hospital stay, and the amount of chest tube drainage between the two groups. However, the amount of transfusion of FFP and platelet in group B was statistically greater than group A. CPB time and cross-clamping time in group B were longer than in group A (p=0.020 and p=0.016, respectively). Univariable analyses revealed that CPB time (>200min), cross-clamping time (>120min), and lowest rectal temperature (<26℃) were independent predictors of difficult conversion of heparin. In multivariable analyses, hemodialysis in patients with chronic renal failure and preoperative low platelet count (<150,000) were associated with difficult conversion (p=0.031 and p=0.017, respectively).
Conclusion : Because difficult conversion of heparin may need greater amount of blood transfusion, surgeon’s efforts to reduce operative time and avoid deep hypothermia should be necessary especially in patients with hemodialysis and low platelet count.
Methods : Between June 2009 and June 2017, 120 consecutive patients underwent open heart surgery or aortic surgery requiring CPB. The patients were classified into the patients with completely conversed ACT by single infusion of protamine (group A, n = 89) and the patients with difficultly conversed ACT requiring addition of protamine infusion one more time (group B, n = 31).
Results : There was no statistical difference in the ICU stay, in-hospital stay, and the amount of chest tube drainage between the two groups. However, the amount of transfusion of FFP and platelet in group B was statistically greater than group A. CPB time and cross-clamping time in group B were longer than in group A (p=0.020 and p=0.016, respectively). Univariable analyses revealed that CPB time (>200min), cross-clamping time (>120min), and lowest rectal temperature (<26℃) were independent predictors of difficult conversion of heparin. In multivariable analyses, hemodialysis in patients with chronic renal failure and preoperative low platelet count (<150,000) were associated with difficult conversion (p=0.031 and p=0.017, respectively).
Conclusion : Because difficult conversion of heparin may need greater amount of blood transfusion, surgeon’s efforts to reduce operative time and avoid deep hypothermia should be necessary especially in patients with hemodialysis and low platelet count.
책임저자: Su Wan Kim
Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
발표자: Min Jung Ku, E-mail : mj99cha@hanmail.net