Utility and safety of nafamostat mesilate for anticoagulation in dogs
Abstract Background Surgical interventions are recommended for cases of advanced mitral regurgitation, however, limited facilities are available. The most prominent complication in such procedures is heparin‐derived bleeding. An alternative anticoagulant to heparin, nafamostat mesilate (NM), can red...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Veterinary Medicine and Science |
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| Online Access: | https://doi.org/10.1002/vms3.1002 |
| _version_ | 1797946533989056512 |
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| author | Noriko Isayama Goki Matsumura Yusuke Uchimura Erika Maeda Kenta Sasaki |
| author_facet | Noriko Isayama Goki Matsumura Yusuke Uchimura Erika Maeda Kenta Sasaki |
| author_sort | Noriko Isayama |
| collection | DOAJ |
| description | Abstract Background Surgical interventions are recommended for cases of advanced mitral regurgitation, however, limited facilities are available. The most prominent complication in such procedures is heparin‐derived bleeding. An alternative anticoagulant to heparin, nafamostat mesilate (NM), can reduce the occurrence of complications associated with heparin such as bleeding or shock. Objectives This study aimed to evaluate the utility and safety of using NM during anaesthesia in canines. Methods Six healthy adult Beagle dogs were anaesthetised, and NM was administered intravenously as a 10 mg/kg bolus dose over 5 min, followed by a continuous infusion of 10 mg/kg/h over 20 min. Blood tests and blood pressure measurements were performed at 0, 5, 25 and 55 min after NM administration. Results Activated thromboplastin times at 0, 25 and 55 min were 13.0 ± 0.7 s, 106.7 ± 13.3 s and 28.2 ± 2.9 s, respectively, with a significant difference between 0 and 25 min (p < 0.01) only. No significant differences were observed in prothrombin time, antithrombin, fibrinogen and fibrin degradation product concentrations between timepoints. Activated clotting times (ACTs) at 0, 5, 25 and 55 min were 119.5 ± 9.6 s, 826.7 ± 78.6 s, 924.8 ± 42.4 s and 165.2 ± 13.5 s, respectively. Significant differences were observed between 0 and 5 min (p < 0.05) and between 0 and 25 min (p < 0.05). Blood pressure changes occurred in four dogs (66.7%). No other serious adverse effects were observed. Conclusions ACT results indicated that NM use in anaesthetised healthy dogs was sufficient to obtain procedural anticoagulation with minimal adverse effects. However, these preliminary data require validation in further studies on cardiopulmonary bypass surgery. |
| first_indexed | 2024-04-10T21:13:25Z |
| format | Article |
| id | doaj.art-ae92c28d3e344c3daf90b3caa817068a |
| institution | Directory Open Access Journal |
| issn | 2053-1095 |
| language | English |
| last_indexed | 2024-04-10T21:13:25Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Veterinary Medicine and Science |
| spelling | doaj.art-ae92c28d3e344c3daf90b3caa817068a2023-01-20T17:53:08ZengWileyVeterinary Medicine and Science2053-10952023-01-0191687510.1002/vms3.1002Utility and safety of nafamostat mesilate for anticoagulation in dogsNoriko Isayama0Goki Matsumura1Yusuke Uchimura2Erika Maeda3Kenta Sasaki4Department of Cardiology Ueno no Mori Animal Hospital Taito Tokyo JapanDepartment of Cardiovascular Surgery The Heart Institute of Japan Tokyo Women's Medical University Shinjyuku‐ku Tokyo JapanDepartment of Cardiology Ueno no Mori Animal Hospital Taito Tokyo JapanDepartment of Cardiology Ueno no Mori Animal Hospital Taito Tokyo JapanDepartment of Cardiology Ueno no Mori Animal Hospital Taito Tokyo JapanAbstract Background Surgical interventions are recommended for cases of advanced mitral regurgitation, however, limited facilities are available. The most prominent complication in such procedures is heparin‐derived bleeding. An alternative anticoagulant to heparin, nafamostat mesilate (NM), can reduce the occurrence of complications associated with heparin such as bleeding or shock. Objectives This study aimed to evaluate the utility and safety of using NM during anaesthesia in canines. Methods Six healthy adult Beagle dogs were anaesthetised, and NM was administered intravenously as a 10 mg/kg bolus dose over 5 min, followed by a continuous infusion of 10 mg/kg/h over 20 min. Blood tests and blood pressure measurements were performed at 0, 5, 25 and 55 min after NM administration. Results Activated thromboplastin times at 0, 25 and 55 min were 13.0 ± 0.7 s, 106.7 ± 13.3 s and 28.2 ± 2.9 s, respectively, with a significant difference between 0 and 25 min (p < 0.01) only. No significant differences were observed in prothrombin time, antithrombin, fibrinogen and fibrin degradation product concentrations between timepoints. Activated clotting times (ACTs) at 0, 5, 25 and 55 min were 119.5 ± 9.6 s, 826.7 ± 78.6 s, 924.8 ± 42.4 s and 165.2 ± 13.5 s, respectively. Significant differences were observed between 0 and 5 min (p < 0.05) and between 0 and 25 min (p < 0.05). Blood pressure changes occurred in four dogs (66.7%). No other serious adverse effects were observed. Conclusions ACT results indicated that NM use in anaesthetised healthy dogs was sufficient to obtain procedural anticoagulation with minimal adverse effects. However, these preliminary data require validation in further studies on cardiopulmonary bypass surgery.https://doi.org/10.1002/vms3.1002anticoagulantscardiac surgerycardiopulmonary bypassmitral valve insufficiency |
| spellingShingle | Noriko Isayama Goki Matsumura Yusuke Uchimura Erika Maeda Kenta Sasaki Utility and safety of nafamostat mesilate for anticoagulation in dogs Veterinary Medicine and Science anticoagulants cardiac surgery cardiopulmonary bypass mitral valve insufficiency |
| title | Utility and safety of nafamostat mesilate for anticoagulation in dogs |
| title_full | Utility and safety of nafamostat mesilate for anticoagulation in dogs |
| title_fullStr | Utility and safety of nafamostat mesilate for anticoagulation in dogs |
| title_full_unstemmed | Utility and safety of nafamostat mesilate for anticoagulation in dogs |
| title_short | Utility and safety of nafamostat mesilate for anticoagulation in dogs |
| title_sort | utility and safety of nafamostat mesilate for anticoagulation in dogs |
| topic | anticoagulants cardiac surgery cardiopulmonary bypass mitral valve insufficiency |
| url | https://doi.org/10.1002/vms3.1002 |
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