Work

The relationship between different anticoagulation monitoring indicators and heparin doses in adult patients with extracorporeal cardiopulmonary resuscitation

Year: 2025

Type: article

Abstract: Objectives Achieving optimal systemic anticoagulation in patients undergoing extracorporeal membrane oxygenation (ECMO) requires precise titration, posing a significant clinical challenge. This study aims to explore the relationship between various anticoagulation monitoring parameters and heparin dosing in adult patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR). Methods A retrospective analysis was conducted on 40 ECPR patients, who were categorized into either the activated clotting time (ACT)-target group or the activated partial thromboplastin time (aPTT)-target group. Anticoagulation monitoring parameters, including aPTT, corresponding ACT, and heparin doses, were collected. Continuous variables are expressed as mean ± SD and compared using Student's t -test. Pearson correlation analysis was performed to examine the relationships between ACT, aPTT, and heparin doses in both groups. Results Of the 40 patients, 16 (40%) died and 24 (60%) survived. Twelve patients (30%) experienced severe bleeding events, while five (12.5%) developed thrombotic complications. Compared with the ACT-target group, the aPTT-target group had higher platelet counts (PLT) and lower blood flow levels ( P < 0.001). Pearson correlation analysis revealed that heparin dose was positively correlated with aPTT ( r = 0.412, P < 0.001) and negatively correlated with blood flow ( r = −0.329, P < 0.001). ACT showed a weak correlation with aPTT ( r = 0.123, P < 0.001). Conclusion Heparin dosing exhibited a stronger correlation with aPTT than with ACT, and blood flow emerged as an important monitoring parameter. Comprehensive anticoagulation monitoring strategies should be employed to evaluate heparin efficacy in ECMO-treated ECPR patients.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2025.1653774

Authors: Jiali Yao, Cong Jin, Tianxing Du, Huizhen Yu

Institutions: Fujian Medical University, Zhejiang University, Fuzhou University

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801