Instructions for use: Ikus - Berlin Heart

9 Intensive care and aftercare
Postoperative anticoagulation therapy
Note
• All information in this chapter constitutes manufacturer recommendations derived from
extensive experience with the EXCOR system and therefore strongly advisable. However,
individual adjustment of the therapy to the patient with due consideration of the
patient’s age, weight, infections or sepsis is essential.
9.1 Postoperative anticoagulation therapy
Patients with EXCOR must receive anticoagulation therapy. In addition, a platelet
aggregation inhibition therapy is recommended (see page 55). The anticoagulation
should begin approx. 12 - 24 h after the operation. So that this can occur without risk to
the patient, a “dry” operation is required, i.e. the patient should experience as little
postoperative bleeding as possible (for infants and young children: no bleeding!).
The setting of the heparin dosage should be checked at regular intervals of 6 h. This can
be done either in the laboratory or with the aid of a PTT fast test (bedside). Once per day,
the coagulation progress should be recorded by means of thromboelastography: The
goal is normal to slightly inhibited global coagulation.
Warning!
• Heparin results in strong thrombocyte activation. Therefore, keep the heparin dose and
the duration of heparin administration as low as possible.
9.1.1 Example: Anticoagulation therapy - Adolescents/adults
Start of therapy
In the first 12 - 24 h postoperatively, no administration of anticoagulants.
After approx. 12 - 24 h, start of heparin administration (i.v.) depending on the
thrombocyte count (>80,000/μl) and bleeding (80s
• If fibrinogen >300g/l: Target PTT 90-100s
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