Issue |
J Extra Corpor Technol
Volume 20, 1988
Proceedings of AmSECT’s 26th International Conference
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Page(s) | 63 - 66 | |
DOI | https://doi.org/10.1051/ject/198820S063 | |
Published online | 25 August 2023 |
Original Article
Demonstration of Heparin Reversal with Protamine Administration Using an Automated Protamine Dose Assay: A Comparison of Two Methods
The Johns Hopkins Medical Institutions, Baltimore, Maryland
* Direct communications to: Dennis C. Rivard, 618 Blalock, Johns Hopkins Hospital, N. Wolfe St., Baltimore, MD 21205.
Systemic heparinization is required in procedures utilizing extracorporeal circulation. Once the procedure is complete, heparinization must be reversed. The drug used to neutralize heparin is protamine sulfate. The complications associated with protamine administration are well documented. An accurate and safe method of determining optimal dose is a clinically desirable tool.
A comparison study of 317 patients was performed using two different methods of protamine dose determinations. The first method utilized the classic Bull heparin dose-activated clotting time (ACT) curve determined prior to bypass. The second consisted of a protamine titration curve constructed using a Hemochron CA510 tube containing diatomaceous earth and a PDA699 tube containing a known amount of lyopholized protamine. The intercept of the protamine titration curve with the baseline ACT was multiplied by patient fluid volume to determine protamine dose. All ACT determinations utilized an automated technique.
A comparison of the two methods showed that 95% of the sample (p<0.001) returned to an ACT baseline with a decreased protamine administration using the protamine titration assay.
© 1988 AMSECT
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