AI Article Synopsis

  • The study aimed to evaluate how post-protamine neutralisation activated clotting time (ACT) influences outcomes in cardiac surgery, like chest drain output, blood transfusion needs, and ICU stay.
  • Conducted at The Aga Khan University Hospital from February to August 2023, it involved analyzing data from 101 elective cardiac surgery patients, split into two groups based on their ACT values.
  • Results showed no significant differences in postoperative outcomes or transfusion needs between the two groups, indicating that maintaining ACT close to baseline might be beneficial without requiring aggressive treatment.

Article Abstract

Objective: To assess the impact of post-protamine neutralisation activated clotting time (ACT) values on postoperative outcomes including chest drain output, transfusion requirements, and CICU stay, in patients undergoing cardiac surgery.

Study Design: Observational comparative study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from February to August 2023.

Methodology: Ethical approval was obtained to collect data from elective cardiac surgery patients' charts. A sequential sampling approach analysed the baseline and post-protamine neutralisation ACT values, categorising patients into two groups. Group A maintained ACT within 10% of baseline, while Group B deviated. The outcomes measured included transfusion needs, chest drain output, additional protamine, cardiac intensive care unit (CICU) stay, and postoperative reopening. Statistical analysis included mean, median, frequency, t-test / Mann-Whitney U test, and Chi-square test.

Results: The study comprised 101 patients (39 in Group A, 62 in Group B), with similar baseline health. No significant differences were found in tranexamic acid use, CICU stay, chest drain output, or transfusion rates between the groups (p >0.05).

Conclusion: Maintaining ACT within 10% of baseline post-protamine neutralisation results in similar intraoperative and postoperative outcomes, suggesting potential benefits in avoiding the aggressive protamine therapy and ensuring haemostasis in cardiac surgery.

Key Words: Coronary Artery bypass grafting, Cardiopulmonary bypass, Activated clotting time (ACT), Heparin, Postoperative bleeding, Blood transfusions.

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Source
http://dx.doi.org/10.29271/jcpsp.2024.11.1280DOI Listing

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