Journal article
An Evaluation of the Effects of a Standard Heparin Dose on Thrombin Inhibition During Cardiopulmonary Bypass in Neonates
Anesthesia and analgesia, v 100(5), pp 1276-1282
May 2005
PMID: 15845669
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We compared the adequacy of heparinization in neonates and older children undergoing cardiopulmonary bypass (CPB) by measuring heparin activity, thrombin formation, and thrombin activity. Ten neonates and 10 older children were administered 400 U/kg of heparin before CPB. Heparin anti-Xa activity, prothrombin fragment 1.2 (F1.2), and fibrinopeptide A (FPA) were measured at baseline, after 30 min on CPB, immediately post-CPB, and 3 and 24 h post-CPB. Heparin anti-Xa activity was significantly decreased during and immediately post-CPB in the neonatal group. F1.2 and FPA levels in neonates were significantly higher at baseline, decreased with the commencement of CPB, and increased to levels higher than those in older children after CPB. Our data show that with standard heparin doses, neonates exhibit less heparin anti-Xa activity during CPB. Higher baseline levels of F1.2 and FPA present in neonates indicate preoperative activation of their coagulation systems as compared with older children. Although F1.2 and FPA levels initially decrease with the commencement of CPB, probably representing hemodilution, the subsequent increase in these markers indicates significantly more thrombin formation and activity during and after CPB. These results raise the concern that 400 U/kg of heparin may not adequately suppress thrombin formation and activity in neonates undergoing CPB.
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Details
- Title
- An Evaluation of the Effects of a Standard Heparin Dose on Thrombin Inhibition During Cardiopulmonary Bypass in Neonates
- Creators
- Nina Guzzetta - Emory UniversityBruce MillerKathy ToddFania SzlamRenee MooreSteven Tosone
- Publication Details
- Anesthesia and analgesia, v 100(5), pp 1276-1282
- Publisher
- International Anesthesia Research Society
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000228755400012
- Scopus ID
- 2-s2.0-17744365791
- Other Identifier
- 991021463546404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Anesthesiology