International Perfusion Association


Category: Anticoagulation

Blood Hero

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluates the methodological quality and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery involving cardiopulmonary bypass (CPB). Analyzing guidelines using the AGREE II tool, it highlights varying consistency across documents, especially in stakeholder involvement. The study reviews drug therapy strategies including anemia therapy, perioperative antithrombotic administration, intraoperative anticoagulation, and hemostatic drug use, noting a lack of pediatric-specific evidence and the cautious use of certain drugs post-surgery.

Heparin Vs.

Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation

This systematic review and meta-analysis evaluated the efficacy and safety of bivalirudin compared to heparin in patients undergoing extracorporeal membrane oxygenation (ECMO). After reviewing eleven studies focusing on short-term mortality, findings revealed that bivalirudin is associated with significantly lower short-term mortality than heparin, with an odds ratio of 0.71. This suggests bivalirudin may be a preferable anticoagulant for patients on ECMO, though further prospective research is needed to confirm these results.


Comparison of Blood Concentration and Weight-Based Heparin and Protamine Dosing Strategies for Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis

This article reviews randomized controlled trials and prospective studies comparing individualized heparin and protamine dosing based on real-time blood heparin concentration versus traditional total body weight methods during cardiopulmonary bypass (CPB). Meta-analysis shows that individualized dosing significantly reduces postoperative blood loss, improves protamine-to-heparin ratios, and increases early postoperative platelet counts. These findings suggest that precision in heparin and protamine dosing could decrease bleeding and transfusion needs, highlighting the potential of machine learning for future advancements in anticoagulation management for CPB.


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