Predictors of Heparin Resistance Before Cardiovascular Operations in Adults

Kawatsu and colleagues performed a retrospective analysis of preoperative characteristics and laboratory data for patients who did and did not exhibit heparin resistance (n = 25 and n = 464, respectively) prior to establishment of cardiopulmonary bypass for a cardiovascular operation. They identified chronic thoracic aortic dissection, smoking, chronic obstructive pulmonary disease, and elevated fibrinogen as independent predictors for heparin resistance. The authors conclude that patients with these predictive factors could potentially be given antithrombin-III if an initial dose of heparin does not achieve the desired activated clotting time, rather than being given an additional heparin dose that may be ineffective.