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The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 674-684, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
BS Bull, RA Korpman, WM Huse and BD Briggs
Five heparin protocols, representative of about 30 presently used
throughout the country, were analyzed. The adequacy of anticoagulation
during and the precision of protamine neutralization at the conclusion of
extracorporeal circulation were studied. In each of 50 patient's age,
height, weight, or surface area was of no help in predicting heparin
kinetics. The study group consisted of the 2 patients with the longest and
the 2 patients with the shortest heparin half lives, as well as the 2
patients who showed the greatest sensitivity to heparin and the 2 who
showed the least. By computer simulation, each was managed according to the
five protocols and by a monitoring procedure. The protocols failed to
provide safe anticoagulation or precise protamine neutralization, whereas
the simplified monitoring approach was uniformly successful.
ARTICLES
Heparin therapy during extracorporeal circulation. I. Problems inherent in existing heparin protocols
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