Optimal Dose of Protamine for Heparin Reversal in
Patients Undergoing Cardiopulmonary Bypass Surgery
Kanlayanee Yongyukantorn MD1, Panthila Rujirojindakul MD2, Orarat Karnjanawanichkul MD1
Affiliation :
1 Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
2 Bumrungrad International Hospital, Bangkok, Thailand
Objective : To compare the heparin reversal effect among three differential protamine doses in 1:1 ratio based on initial heparin dose
(group 1), initial plus additional heparin dose (group 2), and total heparin dose (group 3) in patients undergoing cardiopulmonary
bypass [CPB] surgery.
Materials and Methods : A retrospective review and follow up study was conducted in adult patients undergoing CPB surgery
at a tertiary university hospital. The initial heparin dose, additional heparin dose, total heparin dose, protamine dose, baseline
activated clotting time [ACT] and ACT after heparin reversal were obtained. Effective heparin reversal was de(cid:976)ined as post reversal
ACT within 10% of the baseline ACT value or between 80 to 150 seconds.
Results : Five hundred CPB surgical patients were included in the present study. Effective heparin reversal was achieved in 47.2%,
45.1%, and 55.6% of patients in groups 1, 2, and 3, respectively (p = 0.17). There was no difference in amount of blood loss and
blood transfusion in 24 hours postoperatively.
Conclusion : There was no difference in effectiveness of heparin reversal, postoperative bleeding, and postoperative blood transfusion
among these three differential protamine doses.
Keywords : Cardiac surgery, Dose, Heparin, Protamine
All Articles
Download