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心脏手术后肝素化生理盐水溶液与普通生理盐水溶液对动脉及中心静脉导管全血细胞计数影响的比较

Comparison of the Effect of Heparinized Normal Saline Solution Versus Saline Solutions in Arterial and Central Venous Catheters on Complete Blood Count After Cardiac Surgery.

作者信息

Ziyaeifard Mohsen, Ferasat-Kish Rasool, Azarfarin Rasoul, Aghdaii Nahid, Nejatisini Hasan, Azadi Ahmadabadi Changiz, Yousefi Marziyeh

机构信息

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Department of Surgery, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

Anesth Pain Med. 2022 Aug 23;12(4):e113345. doi: 10.5812/aapm-113345. eCollection 2022 Aug.

Abstract

BACKGROUND

Heparinized and saline solutions can prevent clot formation in arterial and central venous catheters. However, heparin can decrease the platelet count and induce thrombocytopenia. Patients undergoing cardiac surgeries are more likely to develop heparin-induced thrombocytopenia.

OBJECTIVES

This study aimed to investigate the effect of heparinized and saline solutions of arterial and central venous catheters on complete blood count (CBC) after cardiac surgery.

METHODS

This randomized controlled trial was conducted on 100 participants. All subjects underwent cardiac surgery at Rajaie Cardiovascular, Medical, and Research Center, Tehran, Iran. Patients were randomly divided into two groups intervention (A) for whom heparinized normal saline solution was used to maintain central arterial and venous catheters, and control (B) for whom normal saline solution was used. The CBC of subjects was monitored for three days (before surgery and the first and second days after surgery).

RESULTS

In the present study, there were no significant differences between CBC, white blood cell differential count, prothrombin time, partial thromboplastin time (PTT), and international normalized ratio in groups A and B. However, we found significant differences in platelet count (P = 0.049), red blood cell count (P = 0.0001), hemoglobin (P = 0.0001), and hematocrit (P = 0.0001) between before surgery and the second day after surgery in group A. Platelet count (P = 0.027) and PTT (P = 0.0001) before and after surgery were significantly different in group B.

CONCLUSIONS

According to the results of this study, normal saline solution catheters have fewer side effects and can be a suitable replacement for heparinized catheters.

摘要

背景

肝素化溶液和生理盐水可预防动脉和中心静脉导管内的血栓形成。然而,肝素会降低血小板计数并诱发血小板减少症。接受心脏手术的患者更易发生肝素诱导的血小板减少症。

目的

本研究旨在探讨心脏手术后,动脉和中心静脉导管使用肝素化溶液和生理盐水对全血细胞计数(CBC)的影响。

方法

本随机对照试验对100名参与者进行。所有受试者均在伊朗德黑兰的拉贾伊心血管医学与研究中心接受心脏手术。患者被随机分为两组,干预组(A组)使用肝素化生理盐水溶液维持中心动脉和静脉导管,对照组(B组)使用生理盐水溶液。对受试者的全血细胞计数进行三天监测(手术前以及手术后第一天和第二天)。

结果

在本研究中,A组和B组在全血细胞计数、白细胞分类计数、凝血酶原时间、部分凝血活酶时间(PTT)和国际标准化比值方面无显著差异。然而,我们发现A组手术前与术后第二天之间在血小板计数(P = 0.049)、红细胞计数(P = 0.0001)、血红蛋白(P = 0.0001)和血细胞比容(P = 0.0001)方面存在显著差异。B组手术前后的血小板计数(P = 0.027)和PTT(P = 0.0001)存在显著差异。

结论

根据本研究结果,生理盐水溶液导管副作用较少,可作为肝素化导管的合适替代品。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a6a/10392822/1942540f13a2/aapm-12-4-113345-i001.jpg

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