Protamine sulphate and heparin rebound following open-heart surgery

The efficacy of heparin reversal was investigated in 35 patients undergoing open-heart surgery. A total protamine sulphate dose of 3.0 mgs/kg was administered in divided doses and given as a continuous infusion. On this regime complete heparin neutralisation was observed 10 min after decannulation,...

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Bibliographic Details
Published inJournal of cardiovascular surgery Vol. 27; no. 5; p. 600
Main Authors Kesteven, P J, Ahmed, A, Aps, C, Williams, B T, Savidge, G F
Format Journal Article
LanguageEnglish
Published Italy 01.09.1986
Subjects
Adult
Aged
Cardiopulmonary Bypass
Female
Heparin - blood
Heparin - therapeutic use
Humans
Intraoperative Care - methods
Male
Middle Aged
Postoperative Complications - prevention & control
Protamines - administration & dosage
Protamines - therapeutic use
Risk
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Summary:The efficacy of heparin reversal was investigated in 35 patients undergoing open-heart surgery. A total protamine sulphate dose of 3.0 mgs/kg was administered in divided doses and given as a continuous infusion. On this regime complete heparin neutralisation was observed 10 min after decannulation, but heparin levels were again detectable in 29% of cases 2 hours later. This phenomenon was found to correlate with the total circulating load of heparin to be neutralised. All cases with detectable postoperative heparin levels had in-vivo protamine sulphate: heparin ratios of less than 1.6. These data suggest that in-vitro assays of protamine sulphate neutralisation of heparin may seriously underestimate the required dose of protamine sulphate following open-heart surgery.
ISSN:0021-9509