{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T04:20:09Z","timestamp":1746591609964,"version":"3.40.5"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n            <jats:title>Introduction:<\/jats:title>\n            <jats:p>Brigham and Women\u2019s Hospital historically used titratable weight-based heparin nomograms with as needed boluses managed by extracorporeal membrane oxygenation specialists to achieve a predetermined goal-activated partial thromboplastin time (aPTT). Due to concern amongst providers that as needed boluses may lead to supratherapeutic aPTT\u2019s and subsequent bleeding, new nomograms without as needed boluses were implemented. The purpose of this retrospective observational analysis is to provide a comparison in safety and efficacy between the heparin nomograms with as needed boluses and the new nomograms without boluses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Adult patients who were cannulated on extracorporeal membrane oxygenation and initiated on an approved heparin bolus nomogram (January 1, 2018\u2013December 31, 2019) or an approved heparin no-bolus nomogram (October 20, 2020\u2013March 31, 2021) were screened for inclusion. The major endpoint evaluated was the percentage of supratherapeutic aPTTs, defined as an aPTT above the upper limit of the specified nomogram goal, within the first 72 hours.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 23 patients were included in the bolus nomogram cohort and 9 patients in the no-bolus nomogram cohort. Within the first 72 hours of initiation, there were 11.5% supratherapeutic aPTTs in the bolus group and 5.1% in the no-bolus group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.101). Overall there was 1 bleeding event in the no-bolus group (11.1%) and 7 in the bolus group (30.4%) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.26). There were no thromboembolic events in either group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Overall, there was no difference found in the percentage of supratherapeutic aPTTs within the first 72 hours of heparin initiation between the bolus and no-bolus nomograms.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hpc.0000000000000347","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T05:31:38Z","timestamp":1724391098000},"page":"159-165","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of as Needed Heparin Boluses on Supratherapeutic Activated Partial Thromboplastin Time in Patients Managed With Extracorporeal Membrane Oxygenation"],"prefix":"10.1097","volume":"23","author":[{"given":"Delaney M.","family":"Corcoran","sequence":"first","affiliation":[{"name":"From the Department of Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary P.","family":"Kovacevic","sequence":"additional","affiliation":[{"name":"From the Department of Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Dell\u2019Orfano","sequence":"additional","affiliation":[{"name":"From the Department of Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn W.","family":"Sylvester","sequence":"additional","affiliation":[{"name":"From the Department of Pharmacy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean M.","family":"Connors","sequence":"additional","affiliation":[{"name":"Division of Hematology, Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"R1-20250506","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/rth2.12346","article-title":"Hematologic concerns in extracorporeal membrane oxygenation.","volume":"4","author":"Sniderman","year":"2020","journal-title":"Res Pract Thromb Haemost"},{"key":"R2-20250506","doi-asserted-by":"crossref","first-page":"352","DOI":"10.3389\/fmed.2018.00352","article-title":"Current understanding of how extracorporeal membrane oxygenators activate haemostasis and other blood components.","volume":"5","author":"Doyle","year":"2018","journal-title":"Front Med (Lausanne)"},{"key":"R3-20250506","doi-asserted-by":"crossref","first-page":"64S","DOI":"10.1378\/chest.119.1_suppl.64S","article-title":"Heparin and low- molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and 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association.","volume":"103","author":"Hirsh","year":"2001","journal-title":"Circulation"},{"key":"R17-20250506","doi-asserted-by":"crossref","first-page":"178S","DOI":"10.1177\/1076029618798944","article-title":"Time in the therapeutic range for assessing anticoagulation quality in patients receiving continuous unfractionated heparin.","volume":"24","author":"Ting","year":"2018","journal-title":"Clin Appl Thromb Hemost"}],"container-title":["Critical Pathways in Cardiology: A Journal of Evidence-Based 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