ReviewJournal of cardiothoracic and vascular anesthesia2022
Heparin Resistance During Cardiopulmonary Bypass in Adult Cardiac Surgery.
Review in Journal of cardiothoracic and vascular anesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07549568 (Antithrombin as a Predictor of Heparin Resistance in Cardiac Surgery With Cardiopulmonary Bypass), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Antithrombin as a Predictor of Heparin Resistance in Cardiac Surgery With Cardiopulmonary Bypass
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.British journal of anaesthesia · 2025Guideline
- Real-world outcomes of unfractionated heparin plus antithrombin concentrate versus bivalirudin in adult patients undergoing extracorporeal membrane oxygenation.The journal of extra-corporeal technology · 2026Article
- Thromboelastography-Based Risk-Stratified Transfusion Strategy in Acute Stanford Type A Aortic Dissection: A Predictive Model and Prospective Validation.Journal of clinical medicine · 2026Article
- Heparin Anticoagulant Therapy and Its Monitoring.Biomolecules · 2026Review
- Rapid antithrombin assay from human blood plasma utilizing smartphone-based flow observation on paper chips.PLOS digital health · 2026Article
- Heparin Resistance in Cardiac Surgery with Cardiopulmonary Bypass: Mechanisms, Clinical Implications, and Evidence-Based Management.Medicina (Kaunas, Lithuania) · 2025Review
- Heparin resistance in a patient with severe acute pancreatitis: a case report.Laboratory medicine · 2025Article
- Innovative strategies in coagulation management for cardiothoracic surgery: a narrative review of pharmacological and nonpharmacological approaches.Journal of cardiothoracic surgery · 2025Review
- Automated Antithrombin Activity Detection with Whole Capillary Blood Based on Digital Microfluidic Platform.Micromachines · 2025Article
- ICU 'Magic Numbers': The Role of Biomarkers in Supporting Clinical Decision-Making.Diagnostics (Basel, Switzerland) · 2025Review
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Comprehensive Coagulation Management in Cardiac Surgery: Anticoagulants, Heparin Resistance, Monitoring, and Bleeding Risks : Coagulation Management in Cardiac Surgery.Galen medical journal · 2025Review
- Approaches to management of HIT in complex scenarios, including cardiac surgery.Hematology. American Society of Hematology. Education Program · 2024Review
- Heparin-Bead Extraction Enhanced Fluorogenic Aptamer-Thrombin Composite Reporter Enables Sensitive and Rapid Detection of Functional Antithrombin.ACS sensors · 2024Article
- Heparin resistance management during cardiac surgery: a literature review and future directions.The journal of extra-corporeal technology · 2024Review
- The association between heparin sensitivity index and postoperative blood loss in Chinese patients undergoing elective off-pump coronary artery bypass grafting: a single center retrospective study.Journal of cardiothoracic surgery · 2024Article
- Management of Therapeutic-intensity Unfractionated Heparin: A Narrative Review on Critical Points.TH open : companion journal to thrombosis and haemostasis · 2024Review
- Antithrombin Levels and Heparin Responsiveness during Venoarterial Extracorporeal Membrane Oxygenation: A Prospective Single-center Cohort Study.Anesthesiology · 2024Article
- Coatings for Cardiovascular Stents-An Up-to-Date Review.International journal of molecular sciences · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The use of heparin for anticoagulation has changed the face of cardiac surgery by allowing a bloodless and motionless surgical field throughout the introduction of cardiopulmonary bypass (CPB). However, heparin is a drug with complex pharmacologic properties that can cause significant interpatient differences in terms of responsiveness. Heparin resistance during CPB is a weighty issue due to the catastrophic consequences stemming from inadequate anticoagulation, and the treatment of it necessitates a rationalized stepwise approach due to the multifactorial contributions toward this entity. The widespread use of activated clotting time (ACT) as a measurement of anticoagulation during CPB is examined, as it may be a false indicator of heparin resistance. Heparin resistance also has been repeatedly reported in patients infected with COVID-19, which deserves further exploration in this pandemic era. This review aims to examine the variability in heparin potency, underlying mechanisms, and limitations of using ACT for monitoring, as well as provide a framework towards the current management of heparin resistance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.