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The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 685-689, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
BS Bull, WM Huse, FS Brauer and RA Korpman
Because the administration of heparin and protamine according to a set
protocol will fail to anticoagulate safely or neutralize appropriately a
significant number of patients, a method of monitoring heparin therapy
during cardiopulmonary bypass is presented. A dose response curve relating
heparin dosage to its effect on the activated coagulation time (ACT) can be
determined with sufficient accuracy for clinical purposes from three ACT's.
Preparation of such a curve makes it possible to maintain anticoagulation
in a safe range during bypass and minimizes the number of monitoring tests
of coagulation required. At the conclusion of bypass, this curve can be
used to predict the precise amount of protamine needed for neutralization.
Freed from the confusing effects of hyperheparinemia or protamine excess,
the physician can diagnose and treat postoperative bleeding problems much
more readily.
ARTICLES
Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage
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