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J. Cardiothorac. Vasc. Anesth. · Jul 2023
Heparin Loading Dose in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation.
- Lei Zhang, Wei Liu, Jiawei Liu, Peng Sun, Lina Liu, Zhanxiao Liu, and Xudong Wang.
- Department of Emergency Medicine, Aerospace Center Hospital, Beijing China.
- J. Cardiothorac. Vasc. Anesth. 2023 Jul 1; 37 (7): 120112071201-1207.
ObjectiveTo study the differences in hemorrhagic and embolic complications among extracorporeal cardiopulmonary resuscitation (ECPR) patients who received and did not receive a loading dose of heparin.DesignThis study is a controlled before-after monocentric retrospective study.SettingThe emergency department of the Aerospace Center Hospital (ASCH).ParticipantsThe authors studied a total of 28 patients who, after a cardiac arrest, underwent ECPR in the emergency department of the ASCH from January 2018 to May 2022.InterventionsThe authors compared the hemorrhagic and embolic complications and prognosis of the 2 groups based on whether they received a loading dose of heparin anticoagulation therapy before catheterization (a loading-dose group and a non-loading dose- group).Measurements And Main ResultsThere were 12 patients in the loading-dose group and 16 in the nonloading-dose group. There was no statistically significant difference in age, sex, underlying diseases, causes of cardiac arrest, and hypoperfusion time between the 2 groups. The incidence of hemorrhagic complications was 75% in the loading-dose group and 67.5% in the nonloading-dose group. The difference between the 2 groups was not statistically significant (p > 0.05). The incidence of life-threatening massive hemorrhage in the loading-dose group was 50%, and in the nonloading-dose group, it was 12.5%. The difference between the 2 groups was statistically significant (p = 0.03). The incidence of embolic complications in the loading-dose group and nonloading-dose group was 8.3% and 12.5%, respectively, and the difference between the 2 groups was not statistically significant (p > 0.05). The survival rates of the 2 groups were 8.3% v 18.8%, respectively, and the difference between the 2 groups was not statistically significant (p > 0.05).ConclusionIn conclusion, in the authors' study of patients undergoing ECPR, administering a loading dose of heparin was associated with an increased risk of early fatal hemorrhage. However, stopping this loading dose did not raise the risk of embolic complications. It also did not lower the risk of total hemorrhage and transfusion.Copyright © 2023 Elsevier Inc. All rights reserved.
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