Cross-Sectional Investigation of Activated Clotting Time after Administration of Different Intravenous Heparin Doses in Patients Undergoing On-Pump Coronary Artery Bypass Graft Surgery

10109 

Abstract Submission 

Bisma Zulfiqar (1), Hossein Hosseini (2), Bisma Zulfiqar (3), Ali Karami (4), Zeinabsadat Fattahi Saravi (5), Fatemeh Talebi (4)

(1) Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, (2) Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Fars, (3) olom pezeshkiye iran, Shiraz, Iran, (4) Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, (5) Anesthesiology and Critical Care Research Center, ShirazUniversity of Medical Sciences, Shiraz, Iran, Shiraz, Fars

Bisma Zulfiqar    -  Contact Me
Student Research Committee, Shiraz University of Medical Sciences

Hossein Hosseini    -  Contact Me
Student Research Committee, Shiraz University of Medical Sciences

Bisma Zulfiqar    -  Contact Me
olom pezeshkiye iran

Ali Karami    -  Contact Me
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences

Zeinabsadat Fattahi Saravi    -  Contact Me
Anesthesiology and Critical Care Research Center, ShirazUniversity of Medical Sciences, Shiraz, Iran

Fatemeh Talebi    -  Contact Me
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences

Hossein Hosseini    -  Contact Me
Student Research Committee, Shiraz University of Medical Sciences

Introduction: Achieving optimal anticoagulation during coronary artery bypass graft
(CABG) surgery remains a challenge, with variations in heparin response attributed to
differences in demographic and clinical factors. Deviations from the target activated clotting
time (ACT) during CABG have been linked to adverse outcomes. This study aimed to assess
the impact of different intravenous heparin doses on ACT in patients undergoing on-pump
CABG.
Methods: A cross-sectional study was conducted on 54 patients scheduled for CABG surgery
with cardiopulmonary bypass in 2021. ACT measurements were taken 5 minutes after the
initial bolus dose of 200 IU/kg and a secondary dose of 100 IU/kg heparin. Demographic and
clinical data, including ACT measures, hemoglobin levels, bypass time, and mortality, were
collected.
Results: The study population predominantly comprised of male patients, with a mean age of
61.18 ± 8.81 years. The patients and received 4 (3-4) grafts over 75 (65-80) minutes. Baseline
ACT was 149.91±17.48 seconds, increasing to 410 (359-472) and 604 (542-679) seconds
after the initial and additional heparin, respectively. Only 22.2% of the study subjects
achieved target ACT>480 seconds with 200 IU/kg, and the remaining 77.8% required an
additional 100 IU/kg heparin to reach the target ACT. No cases of heparin resistance,
mortality, or dropouts were reported at the end of the study. Preoperative and postoperative
hemoglobin levels were positively correlated (r=0.59, p<0.0001).
Conclusion: A 300 IU/kg heparin dose appears safer than lower doses for initiating
cardiopulmonary bypass in on-pump CABG. Preoperative hemoglobin optimization may help
minimize perioperative hemoglobin drop. Further research is needed to refine dosing
strategies and personalize CABG management.

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