Clinical study on predicted heparin effective dose by in vitro heparin concentration progressive in patients undergoing heart surgery / 实用医学杂志

ABSTRACT

Objective This study explored two methods of predicting the initial dose of heparin by heparin dose response curve(HDR)and in vitro heparin concentration progressive(HCP),and evaluated the predictive value of HCP for precise heparin dosage in patients undergoing cardiac surgery. Method Include 18-65 years old undergoing elective cardiac surgery patients,Before the start of the surgery internal jugular vein blood was taken in-to the HCP(2.5 mg/kg,3.0 mg/kg)test;The first injection of heparin 2 mg/kg via the internal jugular vein, then every 5 minutes each additional heparin 0.5 mg/kg to amount to 2.5 mg/kg,3.0 mg/kg,and measurement ACT and until ACT value≥480 s;According to HDR calculated per patient 2.5,3.0 mg/kg of ACT value;Respective-ly according to the HCP and HDR ACT values obtained by two methods with the actual measured by the correspond-ing value in the body. Results Comparing the ACT values measured by HDR and HCP with the corresponding ACT values in vivoThere are good similarity for heparinization ACT value between HCP and the actual body corresponding concentrations(r was 0.62 and 0.74,respectively),P<0.05;HDR results also have better similar-ity(r was 0.66 and 0.54,respectively),P < 0.05;However,HDR and HCP compared with the actual results in vivo found that in vitro HCP prediction results especially 3.0 mg/kg is more similar with the actual values.Conclu-sions HCP for predicting heparin dosage to meet extracorporeal circulation is more accurate.