Relationship between heparin dosing and coagulation tests after cardiopulmonary bypass in young infants with congenital heart disease and low birth weight北大核心CSCD

ObjectiveTo explore the effect of early heparin anticoagulation on D-dimer of blood coagulation parameters in young and low-birth-weight congenital heart disease (CHD) after cardiopulmonary bypass (CPB). MethodsFrom December 2019 to December 2021, the relevant clinical data were retrospectively reviewed for 102 children undergoing CPB-assisted open-heart surgery for CHD at Shanxi Children's Hospital.There were 57 boys and 45 girls.Based upon an injection of heparin or not, they were assigned into two groups of observation (5 U·kg -1·h -1 low-dose heparin dosing) and control (non-heparin dosing). Fifty-four children in observation group were (119.81±66.90) day in age and (5.4±1.1) kg in weight.And 48 children in control group were (138.00±67.67) day in age and (5.65±1.31) kg in weight.Coagulation functions of two groups were detected preoperatively, postoperatively (admission into CCU), before medication (before heparin on the next day post-operation) and after medication (24h after heparin dosing). The change trends of D-dimer of coagulation function and the difference were observed between two groups.Pearson χ 2 test was utilized for counting data and t-test or Wilcoxon two-sample rank sum test for measurement data. ResultsNo significant inter-group differences existed in gender, age or weight ( P>0.05). No significant inter-group differences in D-dimer distribution pre/postoperatively or before medication ( P>0.05); After medication, D-dimer was significantly lower in observation group than that in control group and the difference was statistically significant ( Z=-2.21, P=0.027). The inter-group change of D-dimer after and before medication was statistically significant ( Z=-2.17, P=0.030). In observation group, D-dimer level continued rising pre/postoperatively and before medication and the difference was statistically significant ( P<0.05); No significant difference existed between before and after medication ( Z=-0.33, P=0.740). The difference was statistically significant after medication and post-operation ( Z=-3.41, P=0.001). The difference of D-dimer was statistically significant after medication as compared with that preoperatively ( Z=-3.06, P=0.002). It was still higher than that pre-operation.In control group, D-dimer continued rising from preoperative to after medication and statistically significant differences existed in D-dimer during each period ( P<0.05). ConclusionsEarly use of low-dose heparin anticoagulant therapy after CPB can relieve the coagulation dysfunction caused by CPB, and is conducive to the prevention of postoperative thrombosis and DIC. © 2023 Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.