Assessment of Clinical Onset of IV Heparin in Interventional Cardiology and Cardiac Surgery
NCT ID: NCT04785885
Last Updated: 2021-09-29
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
40 participants
OBSERVATIONAL
2021-03-09
2022-04-30
Brief Summary
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Detailed Description
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The efficiency and promptness of heparin anticoagulation is necessary during the structural heart procedures to minimize time from insertion of cannulae to valve deployment in cardiac surgery. The time required to prevent major complications is on the order of seconds to minutes. The goal of this study is to determine how rapidly the adequacy of heparin induced anticoagulation occurs using two different point of care ACT technologies (iSTAT and Hemochron). It is hypothesized that anticoagulation can be determined by the iSTAT ACT device 30 seconds after administration of heparin. Measuring heparin effectiveness at 30 or 90 seconds instead of the usual 3-minute time period may allow for earlier cardiac intervention.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Transcatheter Aortic Valve Replacement
Patients receive 100U/Kg of IV heparin. An arterial sample activated clotting time (ACT) will be checked by iStat and hemochron
iStat Handheld Blood Analyzer
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Hemochron
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Cardiac Valve Annuloplasty
Patients receive 300U/kg of IV heparin. An arterial sample activated clotting time (ACT) will be checked by iStat and hemochron
iStat Handheld Blood Analyzer
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Hemochron
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Interventions
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iStat Handheld Blood Analyzer
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Hemochron
An easy-to-use blood analyzer that provides monitoring of heparin anticoagulation quickly for point-of-care testing. Testing will be done at baseline, 30s, 90s and 180s after heparin administration.
Eligibility Criteria
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Inclusion Criteria
* Interventional cardiology patients presenting elective Transcatheter Aortic Valve Replacement (TAVR)
Exclusion Criteria
* Preoperative oral anticoagulant use within 24 hours of surgery
* Platelet count \<120,000U/ml within 24 hours of surgery
18 Years
90 Years
ALL
No
Sponsors
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Rhode Island Hospital
OTHER
Responsible Party
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Principal Investigators
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Shyamal Asher, M.D.
Role: PRINCIPAL_INVESTIGATOR
Rhode Island Hospital, Brown University
Locations
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Rhode Island Hospital
Providence, Rhode Island, United States
Countries
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Central Contacts
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Facility Contacts
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References
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Falter F, MacDonald S, Matthews C, Kemna E, Canameres J, Besser M. Evaluation of Point-of-Care ACT Coagulometers and Anti-Xa Activity During Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth. 2020 Nov;34(11):2921-2927. doi: 10.1053/j.jvca.2020.06.027. Epub 2020 Jun 12.
Bolliger D, Tanaka KA. Point-of-Care Coagulation Testing in Cardiac Surgery. Semin Thromb Hemost. 2017 Jun;43(4):386-396. doi: 10.1055/s-0037-1599153. Epub 2017 Mar 30.
Heres EK, Speight K, Benckart D, Marquez J, Gravlee GP. The clinical onset of heparin is rapid. Anesth Analg. 2001 Jun;92(6):1391-5. doi: 10.1097/00000539-200106000-00006.
Other Identifiers
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1651774
Identifier Type: -
Identifier Source: org_study_id
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