Heparin Based on Ideal Body Weight for Cardiopulmonary Bypass in Obese Patients (HEPOIRINE)
Heparin Management for Cardiopulmonary Bypass in Cardiac Surgery: A Prospective, Comparative and Randomized Study Evaluating a Dosage Based on the Ideal Body Weight in Obese Patients
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 Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Emmanuel HAAS, Doctor
- Phone Number: +33 3.69.55.12.64
- Email: emmanuel.haas@chru-strasbourg.fr
Study Locations
-
-
-
Strasbourg, France, 67091
- Hopitaux Universitaires de Strasbourg
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Obese patients (BMI ≥ 30 kg/m²)
- Planned cardiac surgery under cardiopulmonary bypass
- Coronary-artery bypass graft, or valve surgery)
- Age ≥ 18 yo
Exclusion criteria:
- Allergy to heparin
- Emergency surgical intervention
- Redo surgery
- Heart transplantation
- Surgery for circulatory assistance
- Pre-operative heparin use
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention group
Obese patients, randomized to receive an initial IV bolus of Heparin, before beginning of the cardiopulmonary bypass, at the dosage of 340 UI/kg based on ideal body weight of the obese patients. The objective is to obtain an ACT target ≥ 400 s before the beginning of CPB. If necessary, additional boluses of heparin are administered at the dose of 100 UI/kg based on ideal body weight, to maintain this target during the CPB. |
|
|
Active Comparator: Control group
Obese patients, randomized to receive an initial IV bolus of Heparin, before beginning of the cardiopulmonary bypass, at the usual dosage of 300 UI/kg based on total body weight of the obese patients. The objective is to obtain an ACT target ≥ 400 s before the beginning of CPB. If necessary, additional boluses of heparin are administered at the dose of 100 UI/kg based on total body weight, to maintain this target during the CPB. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Plasma heparin level (anti-Xa activity, in UI/ml)
Time Frame: at 3 minutes after the first heparin injection
|
at 3 minutes after the first heparin injection
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Activated Clotting Time
Time Frame: during the intervention
|
during the intervention
|
|
Plasma Antithrombin III level
Time Frame: during the intervention at 3 minutes after heparin injection (=T1)
|
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
|
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
|
during the first 24 hours in ICU, based on chest tube outputs
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 6124
- 2015-003138-28 (EudraCT Number)
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