A change in anticoagulation monitoring improves safety, reduces transfusion, and reduces costs in infants on cardiopulmonary bypass

Summary Background An immature coagulation system coupled with the hypothermia and hemodilution associated with cardiopulmonary bypass (CPB) in infants makes the activated clotting time (ACT) an ineffective monitor for anticoagulation in this population. The Medtronic HMS Plus Hemostasis Management...

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Bibliographic Details
Published in:Pediatric anesthesia 2015-06, Vol.25 (6), p.580-586
Main Authors: Machovec, Kelly A., Jooste, Edmund H., Walczak, Richard J., Homi, Hercilia Mayumi, Jaquiss, Robert D. B., Lodge, Andrew J., Ames, Warwick A.
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
anticoagulation/blood
Blood Coagulation - physiology
blood component transfusion
Blood Transfusion - statistics & numerical data
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Female
Health Care Costs - statistics & numerical data
heparin
Heparin - therapeutic use
Humans
Infant
Male
Patient Safety - statistics & numerical data
quality improvement
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Summary:Summary Background An immature coagulation system coupled with the hypothermia and hemodilution associated with cardiopulmonary bypass (CPB) in infants makes the activated clotting time (ACT) an ineffective monitor for anticoagulation in this population. The Medtronic HMS Plus Hemostasis Management System (HMS; Medtronic, Inc., Minneapolis, MN, USA) is shown to decrease thrombin generation and blood product requirements. Aim We conducted a quality improvement initiative to test our hypothesis that the use of HMS results in reduced incidence of subtherapeutic ACT values, blood product usage, and operating room time for infants undergoing cardiac surgery. Methods Fifty consecutive patients weighing
ISSN:1155-5645
1460-9592
DOI:10.1111/pan.12591