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Description
Heparin Heuristics Lite
© 2017- JHLConsultants
E-mail: pcumpston@JHLConsultants.com
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. The result of tis trial has been published in the Journal of AtrialFibrillation and Electrophysiology (Cumpston, P., & Phillips, K. P. (2024). A Novel Method for Calculating Heparin Dosing to Rapidly Achieve Target Anticoagulation for Cardiac Procedures. Journal of Atrial Fibrillation, 17(2).)
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. The decision to use this advice must be made by the supervising doctor, and cannot be used to replace clinical judgement.
This application is based on the experience gained when providing anaesthetic care to over 1,000 patients undergoing catheter ablation for atrial fibrillation. 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 (https://www.anzctr.org.au) and approved by the Ramsay Human Ethics Committee: Clinical trial number 18/38 9th October 2019.
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.
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.
This timing is essential for accuracy of subsequent calculations and is critically important.
The application learns as each new patient is added. After the first ten patients, accuracy for the intial heprin dose to achieve the desired ACT moves toward the 86% mark. There will, of course, be outliers. The application allows for dose adjustments based on the measured ACT. Estimates of the protamine dose needed to reverse heparin in the context of catheter ablation cases has been shown to be 97% accurate.
This software is NOT intended by its manufacturer to:
(a) be used for the sole purpose of providing alerts to health professionals in relation to patient care; and
(b)
(i) replace the clinical judgement of a health professional; or
(ii) diagnose, screen for, prevent, alleviate, treat, or make a decision about the treatment of, a disease, condition, ailment or defect
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.
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.
It is up to the individual practitioner to use their best judgment when using this application. It is not intended to replace clinical judgement by experience operators. 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.
The heparin image is taken from Public Domain, https://commons.wikimedia.org/w/index.php?curid=1034324
Information and links to citations forming the basis for the theoretical development of this app can be found at: https://HeparinHeuristics.com
What's New in Version iOS App Version 7.6
Support for modification of infusion rates according to the difference between the desired and achieved ACT. Improved algorithm for helping to determine the suggested dose of heparin to achieve a desired ACT. The app now uses the 20% trimmed median value for prediction of the initial heparin dose, and this is adjusted after each patient is added to the data.
Seller
Name
Philip Cumpston
Information
Developer
Categories
Version
iOS App Version 7.6
Size
11.4 MB
Game Center
No
VPP Device Licensing
Yes
Rating
Rated: 17+
Compatibility
iOS 14.0 or later
Devices
iPhone 5s, iPhone 6, iPhone 6 Plus, iPhone 6s, iPhone 6s Plus, iPhone SE, iPhone 7, iPhone 7 Plus, iPhone 8, iPhone 8 Plus, iPhone X, iPhone XR, iPhone XS, iPhone XS Max, iPhone 11, iPhone 11 Pro, iPhone 11 Pro Max, iPhone SE (2nd generation), iPhone 12, iPhone 12 Pro, iPhone 12 Pro Max, iPhone 12 mini, iPhone 13, iPhone 13 Pro, iPhone 13 Pro Max, iPhone 13 mini, iPhone SE (3rd generation), iPhone 14, iPhone 14 Plus, iPhone 14 Pro, iPhone 14 Pro Max, iPhone 15, iPhone 15 Plus, iPhone 15 Pro, iPhone 15 Pro Max, iPhone 16, iPhone 16 Plus, iPhone 16 Pro, iPhone 16 Pro Max, iPhone 16e, iPhone 17, iPhone 17 Pro, iPhone 17 Pro Max, iPhone Air, iPhone 17e, iPad (5th Generation) Wi-Fi, iPad (5th Generation) Wi-Fi + Cellular, iPad (6th generation) Wi-Fi, iPad (6th generation) Wi-Fi + Cellular, iPad Pro, iPad Pro (Cellular), iPad Pro (9.7-inch), iPad Pro (9.7-inch) (Cellular), iPad Pro 12.9-inch (2nd generation), iPad Pro 12.9-inch (2nd generation) Wi-Fi + Cellular, iPad Pro (10.5-inch), iPad Pro (10.5-inch) Wi-Fi + Cellular, iPad Pro (11-inch), iPad Pro (11-inch) Wi-Fi + Cellular, iPad Pro 12.9-inch (3rd generation), iPad Pro 12.9-inch (3rd generation) Wi-Fi + Cellular, iPad Air, iPad Air (Cellular), iPad Air 2, iPad Air 2 (Cellular), iPad Air (3rd generation), iPad Air (3rd generation) Wi-Fi + Cellular, iPad mini Retina, iPad mini Retina (Cellular), iPad mini 3, iPad mini 3 (Cellular), iPad mini 4, iPad mini 4 (Cellular), iPad mini (5th Generation), iPad mini (5th Generation) Wi-Fi + Cellular, iPad (7th generation) Wi-Fi + Cellular, iPad Pro 11-inch (2nd generation), iPad Pro 11-inch (2nd generation) Wi-Fi + Cellular, iPad Pro 12.9-inch (4th generation), iPad Pro 12.9-inch (4th generation) Wi-Fi + Cellular, iPad Air (4th Generation) (Wi-Fi), iPad Air (4th Generation) (Wi-Fi + Cellular), iPad (8th generation) Wi-Fi, iPad (8th generation) Wi-Fi + Cellular, iPad Pro 11-inch (3rd generation), iPad Pro 11-inch (3rd generation) Wi-Fi + Cellular, iPad Pro 12.9-inch (5th Generation), iPad Pro 12.9-inch (5th Generation) Wi-Fi + Cellular, iPad (9th Generation), iPad (9th Generation) Wi-Fi + Cellular, iPad mini (6th Generation), iPad mini (6th Generation) Wi-Fi + Cellular, iPad Air (5th generation), iPad Air (5th generation) Wi-Fi + Cellular, iPad Pro 11-inch (4th generation), iPad Pro 11-inch (4th generation) Wi-Fi + Cellular, iPad Pro 12.9-inch (6th generation), iPad Pro 12.9-inch (6th generation) Wi-Fi + Cellular, iPad (10th generation), iPad (10th generation) Wi-Fi + Cellular, iPad Air 11-inch (M2) Wi-Fi, iPad Air 13-inch (M2) Wi-Fi, iPad Air 13-inch (M2) Wi-Fi + Cellular, iPad Pro 11-inch (M4) Wi-Fi, iPad Pro 11-inch (M4) Wi-Fi + Cellular, iPad Pro 13-inch (M4) Wi-Fi, iPad Pro 13-inch (M4) Wi-Fi + Cellular, iPad mini (A17 Pro) Wi-Fi, iPad mini (A17 Pro) Wi-Fi + Cellular, iPad (A16) Wi-Fi, iPad (A16) Wi-Fi + Cellular, iPad Air 11-inch (M3) Wi-Fi, iPad Air 11-inch (M3) Wi-Fi + Cellular, iPad Air 13-inch (M3) Wi-Fi, iPad Air 13-inch (M3) Wi-Fi + Cellular, iPad Pro 11-inch (M5) Wi-Fi, iPad Pro 11-inch (M5) Wi-Fi + Cellular, iPad Pro 13-inch (M5) Wi-Fi, iPad Pro 13-inch (M5) Wi-Fi + Cellular, iPad Air11M4, iPad Air11M4Cellular, iPad Air13M4, iPad Air13M4Cellular, iPod touch (6th Generation), iPod touch (7th generation)
Languages
English, Chinese, Dutch, French, German, Greek, Italian, Japanese, Norwegian Bokmål, Spanish, Turkish
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