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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 539-541, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Comparison of two protocols for heparin neutralization by protamine after cardiopulmonary bypass

C Aren, K Feddersen and K Radegran
Department of Thoracic Surgery, Sahlgrenska sjukhuset, Goteborg, Sweden.

Twenty patients undergoing cardiac operations were randomly assigned to two protocols for heparin neutralization by protamine after cardiopulmonary bypass. In all patients protamine chloride was given at a ratio of 1 unit of protamine to 1 unit of injected heparin. In Group I (10 patients) all protamine was infused within 10 minutes after termination of cardiopulmonary bypass. Group II (10 patients) received 75% of the calculated protamine dose within 10 minutes after termination of bypass and the remainder after transfusion of all blood in the heart-lung machine. Plasma heparin levels were significantly lower in Group II 5 minutes after transfusion of all blood in the heart- lung machine and were 0.13 units/ml (standard deviation 0.04) in Group I and 0.06 units/ml (standard deviation 0.05) in Group II (p less than 0.001) 60 minutes after bypass. Activated partial thromboplastin time mirrored the changes in plasma heparin, whereas activated clotting time (Hemochron) was too insensitive to detect these low plasma heparin levels. We conclude that the two-dose protocol resulted in more complete heparin neutralization than the one-dose protocol.

This article has been cited by other articles:

				P. Svenarud and E. Ovrum Clinical Effects of Different Protamine Doses After Cardiopulmonary Bypass Asian Cardiovasc Thorac Ann, June 1, 2002; 10(2): 119 - 123. [Abstract] [Full Text] [PDF]

				C. Aren Review article : Heparin and protamine during cardiac surgery Perfusion, July 1, 1989; 4(3): 171 - 181. [PDF]