ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The incidence of heparin resistance in patients undergoing open heart surgery and an evaluation of treatment strategies: a retrospective study
Dilek Kazancı, Bahar Aydınlı, Sema Turan, Aslı Dönmez, Ahmet Saraç, Eslem İnce, Mine Chavush, Ayşegül Özgök
Department of Anaesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara Turkey
DOI : 10.5606/tgkdc.dergisi.2013.7972
Background: This study aims to identify the incidence of heparin resistance in patients undergoing open heart surgery and to evaluate treatment strategies.

Methods: January 2010 and December 2010, 1101 consecutive open heart surgery patients were retrospectively analyzed using their anesthetic charts. Demographic data of the patients, activated coagulation time (ACT), administration of additional heparin dose, fresh-frozen plasma, and antithrombin III (AT-III) treatments were recorded. Statistical analysis was performed based on frequency tables and median calculation in all categories.

Results: Of patients, 409 patients (37%) received additional heparin once (n=305) and twice (n=54). Forty-nine patients (4.45%) with normal ACT levels (<450 sec) after second additional heparin dose, received fresh frozen plasma. Antithrombin-III treatment was given to two patients (0.18%). A total of 37% patients needed higher doses of heparin with a 4.45% and 0.18% incidence of fresh frozen plasma and AT-III treatments respectively. The incidence of heparin resistance was 4.6%.

Conclusion: Our study results showed that the most frequently preferred treatment modality was fresh-frozen plasma application in patients with heparin resistance to achieve normal ACT levels.

Keywords : Cardiopulmonary bypass; heparin; resistance
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