A single-center retrospective cohort compared half-dose versus standard-dose heparin flushes in 128 patients with cardiogenic shock receiving IABP support. Half-dose flushes were associated with lower clinically significant bleeding odds (odds ratio 0.15; 95% confidence interval 0.03–0.68), with regression adjusting for dual antiplatelet therapy and renal dysfunction. Thrombocytopenia and transfusion requirements were also significantly lower with half-dose flushes, although absolute event rates were not reported in the abstract. No statistically significant differences were reported in in-hospital mortality or catheter-related occlusion, and neither group had observed device-related thrombotic events.
This cohort suggests an association between half-dose heparin flushes and fewer bleeding-related complications during IABP support. It does not establish comparative thrombotic safety or a mortality benefit.
Study limitation: The small, single-center retrospective cohort is vulnerable to residual confounding and cannot establish safety from infrequent or absent thrombotic events.
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