The optimal heparin regimen during cardiopulmonary bypass (CPB) has not been well established in obese patients. Results of a preview study show that the standard heparin management based on total body weight in obese patients during CPB resulted in excessive heparin level, which could lead to excessive postoperative bleeding. To avoid this overdosing, an initial heparin bolus based on ideal body weight in obese patients was proposed. The main objective of the study is to evaluate the effects of heparin injection, based on ideal body weight, on intraoperative plasma heparin levels and activated coagulation time (ACT) in a population of obese patients, compared to a group of obese patients undergoing CPB surgery with heparin management based of total body weight. The secondary objectives are to evaluate the relationship between heparin level and ACT in each group of patients and at different time points during CPB, and to compare the incidence of bleeding, intraoperative transfusions and complications in the two groups of patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Hôpitaux Universitaires de Strasbourg
Strasbourg, France
Plasma heparin level (anti-Xa activity, in UI/ml)
Time frame: at 3 minutes after the first heparin injection
Activated Clotting Time
Time frame: during the intervention
Plasma Antithrombin III level
Time frame: during the intervention at 3 minutes after heparin injection (=T1)
numbers of labile blood products transfused
Time frame: during the surgery and the first 24 hours in ICU
Postoperative bleedings
Time frame: during the first 24 hours in ICU, based on chest tube outputs
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