第四届心血管科学国际研讨会(ICCS 2024)

会议时间： 2024年7月19-21日
会议地点：中国 西安 
会议官网：https://www.academicx.org/ICCS/2024/

会议日期：2024年7月19-21日
会议地点：中国 西安(线下会议)
稿件提交截止日期：2024年7月1日
报名截止日期：2024年7月1日
 
会议简介：
 第四届心血管科学国际研讨会 (ICCS 2024) 将于2024年7月19-21日在中国西安举行。ICCS 2024议题涵盖心血管药物和治疗，心血管外科/临床心脏病学，心血管干预，移植/再生/心血管工程, 预防/流行病学，心血管成像/超声心动图，心血管药理学/毒理学，心血管转化研究，心血管疾病的护理等。本届大会将继续遵循学术性、国际性的原则，特邀国内外化学相关领域内的学者专家前来参会，并做出精彩的报告。本次会议秉持学术性和国际性原则，旨在邀请国内外化学领域的学者和专家参与研讨，并进行精彩的报告。我们将为与会者提供一个互动的平台，促进最新研究成果的交流，并分享相关领域中的先进研究方法。
  
会议论文发表

 录用的论文将发表在国际英文开源期刊Journal of Biosciences and Medicines（ISSN Print: 2327-5081、ISSN Online: 2327-509X）上。

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感兴趣的提交主题包括但不限于：
基础科学/心血管电生理学和病理学 
心律失常/心房颤动/心室颤动 
瓣膜性心脏病/ TAVR 
缺血/冠状动脉疾病/急性冠状动脉综合征 
心力衰竭/左心室功能/心肌疾病/心包炎 
先天性心脏病 心脏骤停/心脏猝死 
心绞痛/动脉粥样硬化/动脉瘤/血栓形成 
主动脉/外周血管疾病 
循环/微循环/血管生成 
高血压/低血压 
血脂异常 
中风 
心脏肿瘤 
心血管药物和治疗 
心血管外科/临床心脏病学 
心血管干预 
移植/再生/心血管工程 
预防/流行病学 
心血管成像/超声心动图 
心血管药理学/毒理学 
心血管转化研究 
心血管疾病的护理 
其他相关主题
 
特邀演讲嘉宾
 
Prof.  Xiaopeng  Zhang
Department of Anesthesiology, Geisinger Clinic, 100 North Academy Avenue, Danville, PA,  USA
Title: Comparison of blood concentration based- versus conventional heparin and protamine dosing strategies for cardiopulmonary bypass
Abstract:
Importance: The conventional method of heparin and protamine management during cardiopulmonary bypass (CPB) is based on total body weight (TBW) which fails to account for the heterogenous response to unfractionated heparin (UFH) in each individual patient. Although inaccurate heparin dosing and reversal may lead to adverse postoperative outcomes, the literature is inconclusive on whether individualized anticoagulation management based on real-time blood heparin concentration (HC) improves post-CBP outcomes.
 
Objective: To conduct a meta-analysis comparing post-CPB outcomes in patients receiving conventional versus individualized anticoagulation management.
 
Data Sources: This systematically searched the databases: Medline, EMBASE, PubMed, CINHL and Google Scholar for full text papers published up until March 2023.
 
Study Selection: We recruited randomized controlled trials (RCTs) and prospective studies comparing the outcomes of dosing heparin and/or protamine for adults undergoing CPB based on measured HC versus TBW. Papers were excluded if they involved pediatric patients and patients of extracorporeal membrane oxygenation (EMCO) or studied non-CPB cardiovascular interventions.
 
Data Extraction and Synthesis: The literature search was conducted following the PRISMA guidelines. Data was extracted independently by multiple observers. Random effects meta-analyses were conducted to compare the outcome profiles of these two interventions. 
 
Main Outcomes and Measures: Primary endpoints include postoperative blood loss, transfusion requirements, heparin rebound, and reoperation for bleeding. The hypothesis and endpoints were formulated prior to data collection.
 
Results: We enrolled 25 articles including 25 RCTs and 4 prospective cohort studies involving 3810 patients.  Compared to TBW based heparin dosing, patients in HC group had significantly higher total heparin dose (MD=65.61mg, 95% CI:32-99.21mg), significantly lower protamine to heparin ratio (MD = 0.29, 95% CI: 0.18-0.41), significant higher early postoperative platelet counts (MD = 8.83, 95% CI: 2.07-15.69), and significantly reduced total postoperative blood loss (MD = 51.13 ml, 95% CI: 8.79-93.49 ml).  The random-effects meta-regression indicated that the changes in total protamine reversal dose (PD p= 0.0467) and total heparin dose(THD) or combined with length of aortic cross clamping time (p= 0.04) were associated with increasing postoperative blood loss.  There were no significant differences in CPB duration, aortic cross clamping time, postoperative red blood cell transfusion, incidences of heparin rebound, or chest wound re-exploration for bleeding.
 
Conclusions and Relevance: Compared to TBW based heparin dosing, individualized HC based management may beneficially preserve platelet count and function while reducing postoperative blood loss. The significant correlation between PD and THD with post operative blood loss suggests that precise dosing of protamine and heparin may reduce postoperative bleeding. Dosing protamine based on residual heparin may be mandatory.  Accurate prediction of dosing of heparin may require new technology, e.g., machine learning which has more power to process mega volume of clinical data, result in best algorithm for estimating heparin dosage.
Key point
Question: Does individualized heparin management reduce post operative blood loss in patients undergoing cardiac surgery requiring cardiopulmonary bypass?
Findings: This systematic review and meta-analysis compared strategies of conventional heparin dosing based on total body weight versus individualized heparin management based on in vitro heparin dose response calculations. The individualized Strategy resulted in significantly reduced post-operative blood loss, as well as reduced protamine/heparin dose ratio, and higher platelet counts.  There is a confounding finding where the total heparin dose was found to be significantly higher in the intervention group. The meta-regression showed that total heparin dose combined with aortic cross clamping time was predictive of post operative blood loss, the likely explanation would be that other than iatrogenic overdosing, the intervention group could have heparin overdose from inaccurate heparin dose response curve.  Bleeding could be further reduced if less heparin were given. In addition, the assumption of one-compartment pharmacokinetic model of heparin metabolism and the linear relationship between heparin dose and ACT/or heparin concentration may be inaccurate.
Meaning: During cardiopulmonary bypass, heparin anticoagulation management should be individualized based on accurate prediction of protamine and heparin dose response. The cumulative clinical data of heparin dose response may require machine learning which offers greater data processing power to generate accurate mathematical equations taking consideration of patient-subjective variables in heparin administration.
 
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该学术会议为网页翻译，学术会议内容可能会有差异，一切以官网为准-会议官网：http://www.academicx.org/ICCS/2024/