Effect Of Heparin Dose On Postoperative Bleeding In Patients Undergoing Cardiopulmonary Bypass

Subject:To explore the effect of heparin dose on postoperative bleeding in patients undergoing cardiopulmonary bypass heart surgery,and to provide a strong basis for clinical practice and rational implementation of individualized medication,so as to reduce perioperative bleeding during cardiac surgery and improve the prognosis and postoperative outcome of patients.Method:The Cardiopulmonary bypass(CPB)cardiac surgery was performed in 137 adult patients under general anesthesia.Patients were divided into three groups according to the heparin dose given at the first kg of body weight:① Low-dose group(initial heparin dose<300 IU/kg,n=39);② Medium dose group(initial heparin dose 300 IU/kg～450 IU/kg,n=50);③High dose group(initial heparin dose>450 IU/kg,n=48);Indexes such as thoracic drainage volume and perioperative blood transfusion within 24 hours after surgery were recorded in each group,and general,surgical and prognostic data were recorded in detail for comparison.Results:The postoperative blood loss of the three groups was significantly different within 24 hours after surgery(p<0.05).The postoperative blood loss of the patients receiving high dose heparin was significantly higher than that of the patients receiving low dose.The intraoperative infusion of concentrated red blood cells and postoperative fresh plasma in the high dose group were increased(p<0.05).Pairwise comparison between the groups showed that the blood loss within 24 hours after surgery,intraoperative concentrated red blood cell infusion and postoperative fresh plasma infusion were as follows:high-dose group>medium-dose group>low-dose group,and the difference was statistically significant(p<0.05).The proportion of patients with postoperative blood transfusion and serious bleeding in high-dose group were significantly increased(p<0.05).Conclusions:Intraoperative high dose heparin can increase the risk of postoperative bleeding and the need for intraoperative and postoperative transfusion of blood products,which is not conducive to the prognosis and outcome of patients.Low dose heparin high dose heparin is relatively safe,which is beneficial to improve the prognosis of patients and reduce postoperative bleeding and other complications.Therefore,high dose of heparin should be avoided during the operation,and the lowest effective dose should be actively used and individualized medication should be reasonably implemented to strengthen perioperative blood protection in patients with cardiopulmonary bypass.