Heparin Heuristics Lite is a Medical app by Philip Cumpston. Heparin Heuristics Lite © 2017- JHLConsultants E-mail: [email protected] This application is based on the experience gained when providing anaesthetic care to over 1,000 patients undergoing catheter ablation for atrial fibrillation, and resulted from an approved clinical trial.
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1. It was developed during a clinical trial entitled "A Heuristic Approach to determine the optimal method of Heparin Dosing and Reversal in all Patients Undergoing Anaesthesia for Catheter Ablation for Atrial Fibrillation (CA-AF)", ANZCTR Trial Id: ACTRN12618001489280 ( ) and approved by the Ramsay Human Ethics Committee: Clinical trial number 18/38 9th October 2019.
2. This application is based on the experience gained when providing anaesthetic care to over 1,000 patients undergoing catheter ablation for atrial fibrillation, and resulted from an approved clinical trial.
3. Disclaimer: This application must only be used by health professionals in the course of providing care to patients undergoing procedures where anticoagulation is required by the use of intravenous heparin, and where it is desired to reverse the anticoagulation with protamine.
4. As each patient has details added, the application moves toward the average for the initial heparin dose calculations, but always uses the individual patient response to heparin to estimate the appropriate change in heparin bolus to achieve the desired ACT.
5. This application is based on the experience gained when providing anaesthetic care to over 1,000 patients undergoing catheter ablation for atrial fibrillation.
6. The ACT must then be measured ten minutes after the inital heparin bolus and the result entered into the application in order to calculate the patient's individual ACT:heparin dose-response relationship.
7. While this application helps guide the administration, maintenance and reversal of heparin, it is important to note that a normal ACT does not necessarily mean that there is no residual heparin, and does not mean that there is not an excess of protamine after reversal of heparin.
8. Estimates of the protamine dose needed to reverse heparin in the context of catheter ablation cases has been shown to be 97% accurate.
9. It can be used to estimate the initial bolus of heparin needed to achieve a desired ACT, given height, weight, sex, ACT before heparin and desired ACT.
10. After the first ten patients, accuracy for the intial heprin dose to achieve the desired ACT moves toward the 86% mark.
11. For example, a protamine: heparin ratio of 0.8 to 1 may be considered optimal by some practitioners, but others may prefer the traditional 1:1 ratio.
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