It is hypothesized that anticoagulation with a target ACT > 400 seconds is equivalent to a target ACT > 480 seconds with respect to packed red blood cell (PRBC) transfusion rates during hospitalization in patients undergoing cardiac surgery…
ID
Bron
Verkorte titel
Aandoening
Heart diseases
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Packed red blood cell (PRBC) transfusion rates during hospitalization
Achtergrond van het onderzoek
Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) require full anticoagulation to inhibit thrombin production, reduce clot formation and activation of the coagulation system. Worldwide, but also in the Netherlands, various target activated clotting time (ACT) values are used during CPB. While part of the centers use a target ACT > 480 seconds, others use an ACT > 400 seconds. Due to the lack of large randomized controlled trials in modern cardiosurgical settings it is unclear which target ACT is associated with the most favorable hemostatic profile following cardiac surgery. The present study therefore aims to investigate the impact of a minimal target ACT of 400 or 480 seconds, respectively, on transfusion rates, postoperative blood loss and reoperations in patients undergoing cardiac surgery with cardiopulmonary bypass.
Doel van het onderzoek
It is hypothesized that anticoagulation with a target ACT > 400 seconds is equivalent to a target ACT > 480 seconds with respect to packed red blood cell (PRBC) transfusion rates during hospitalization in patients undergoing cardiac surgery with cardiopulmonary bypass.
Onderzoeksopzet
N/A
Onderzoeksproduct en/of interventie
Heparin anticoagulation during cardiopulmonary bypass with a target ACT of 400 seconds versus a target ACT of 480 seconds
Algemeen / deelnemers
Wetenschappers
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
• Patients scheduled for elective CABG or cardiac valve surgery, or a combination of CABG with valve surgery, or (cross-clamped) aortic root or ascendens procedures with cardiopulmonary bypass.
• Adult surgery
• Informed consent
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
• Re-operations
• Aorta surgery (requiring SCP and/or circulatory arrest)
• Emergency operation
• Minimized extracorporeal circuits (MECC)
• Deep hypothermia (<32oC)
• Patients with congenital coagulation factor abnormalities (e.g. von Willebrand disease, hemophilia)
• Patients with acquired coagulation factor abnormalities (e.g. acquired haemophilia, acquired von Willebrand disease, haematological malignities, thrombocytopenia <75*109/L)
• Patients with anemia (hemoglobin value < 6.5 mmol/l)
Opzet
Deelname
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL7575 |
| CCMO | NL64741.041.18 |
| OMON | NL-OMON52711 |