Anticoagulation management during multivessel coronary artery bypass grafting: a randomized trial comparing individualized heparin management and conventional hemostasis management

Summary Background Individualized heparin management (IHM) uses heparin dose–response curves to improve hemostasis management during cardiac surgery as compared with activated clotting time‐based methods. Objectives IHM was compared with conventional hemostasis management (CHM) in a randomized, prospective study (ID DRKS00007580). Methods One‐hundred and twenty patients undergoing multivessel coronary artery bypass grafting (CABG) were enrolled. Heparin and protamine consumption, blood losses, blood transfusions and administration of hemostatic agents were recorded. Time courses of platelet counts and of coagulation parameters were determined. Coagulation was analyzed at intensive care unit (ICU) arrival by thromboelastometry. Results IHM patients received significantly lower initial heparin doses (289.3IU kg−1 [interquartile range (IQR) 221.5–376.2 IU kg−1] versus 350.5 IU kg−1 [IQR 346.8–353.7 IU kg−1], P