Paediatric anaesthesia
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Paediatr Anaesth
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Paediatric anaesthesia · Jun 2015
A change in anticoagulation monitoring improves safety, reduces transfusion, and reduces costs in infants on cardiopulmonary bypass.
An immature coagulation system coupled with the hypothermia and hemodilution associated with cardiopulmonary bypass (CPB) in infants makes the activated clotting time (ACT) an ineffective monitor for anticoagulation in this population. The Medtronic HMS Plus Hemostasis Management System (HMS; Medtronic, Inc., Minneapolis, MN, USA) is shown to decrease thrombin generation and blood product requirements. ⋯ Our findings highlight the benefits of individualized heparinization for pediatric patients undergoing CPB with a monitored heparinization system.