Pediatric anesthesia & critical care
Risk Factor Analysis of Inadequate Heparin Response in Pediatric Cardiac Surgery
Authors' conclusion
Inadequate heparin response is common in pediatric cardiac surgery.
Study context
- Population
- Pediatric patients (age <18 years) undergoing congenital heart surgery on CPB, December 2022–May 2024
- Participants
- 1,746 surgical procedures
- Exposure
- Neonates vs Non-neonates
- Outcome
- Inadequate heparin response (activated clotting time <400 seconds after standard weight-based heparin bolus)
Methodological detailssingle tertiary centre
- Single tertiary centre
Main finding
As reported in the abstract
Inadequate heparin response (ACT <400 seconds after standard weight-based heparin bolus)
- Inadequate heparin response, all 1,746 surgical procedures
- 220 (12.6%)
- Non-neonatal risk score discrimination (fair), AUC
- 0.775
- Neonatal risk score discrimination (good), AUC
- 0.827
Observational data: associations, not effects.
Further findings
Risk factors, non-neonates
- Associated with surgical urgency, higher platelet count (≥380 K/µL), and higher absolute neutrophil count (≥4.6 K/µL)
Risk factors, neonates
- Associated with lower hematocrit (<43%), lower absolute neutrophil count (<8.6 K/µL), and higher fibrinogen level (≥185 mg/dL)
Original publication
Risk Factor Analysis of Inadequate Heparin Response in Pediatric Cardiac Surgery. J Cardiothorac Vasc Anesth. Published 16 April 2026. doi:10.
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