HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Eivind Øvrum Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Svenarud, P. Articles by Øvrum, E. Search for Related Content PubMed PubMed Citation Articles by Svenarud, P. Articles by Øvrum, E. Related Collections Extracorporeal circulation

Clinical Effects of Different Protamine Doses After Cardiopulmonary Bypass

Oslo Heart Center Oslo, Norway
Peter Svenarud, MD Tel: 46 8 5858 6726 Fax: 46 8 5858 6740 email: peter.svenarud{at}thsurg.hs.sll.se Department of Cardiothoracic Surgery and Anesthesiology (M85), Karolinska Institutet, Huddinge University Hospital, Stockholm SE-14186, Sweden.

The optimal dose of protamine needed to reverse the anticoagulant effect of heparin after cardiopulmonary bypass is still not known. In this retrospective cohort study, we investigated 3 different dose regimes in 300 patients undergoing coronary artery bypass grafting. Group A patients (n = 100) were given protamine in the ratio of 1.3 mg to 1 mg heparin, group B patients (n = 100) were given 0.75 mg protamine to 1 mg heparin, and group C patients (n = 100) were given protamine in fractionated doses of 1 mg + 0.15 mg + 0.15 mg to 1 mg heparin. The groups were comparable in all major clinical and operative variables. The heparin dose was almost identical in the groups. The rate of red cell transfusion was significantly higher in group B than in the other groups. A similar but nonsignificant trend was observed in the incidence of resternotomy for postoperative bleeding, mediastinal drainage, and postoperative hemoglobin loss. The study demonstrates that a single bolus dose of 1.3 mg protamine to 1 mg heparin is safe and efficient for neutralizing heparin after cardiopulmonary bypass.

This article has been cited by other articles:

				J. H. Levy and K. A. Tanaka Anticoagulation and Reversal Paradigms: Is Too Much of a Good Thing Bad? Anesth. Analg., March 1, 2009; 108(3): 692 - 694. [Full Text] [PDF]

				M. Mittermayr, C. Velik-Salchner, B. Stalzer, J. Margreiter, A. Klingler, W. Streif, D. Fries, and P. Innerhofer Detection of Protamine and Heparin After Termination of Cardiopulmonary Bypass by Thrombelastometry (ROTEM(R)): Results of a Pilot Study Anesth. Analg., March 1, 2009; 108(3): 743 - 750. [Abstract] [Full Text] [PDF]