Adjusted calculation model regarding heparin and protamine in connection with cardiopulmonary bypass by
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Monitoring Heparin and Protamine Therapy during Cardiopulmonary Bypass by Activated Clotting time
Cardiopulmonary bypass depends on our ability to control the coagulation system. Heparin and protamine have been used for this purpose since the introduction of cardiopulmonary bypass. Although heparin has been used as an anticoagulant since 1935 there are still some unsolved questions as regarding its structure and metabolism. 1•2 Many principles have been proposed for total heparinization, mo...
متن کاملComplement activation during cardiopulmonary bypass by heparin-protamine interaction.
Circulating concentrations of split products of the third complement factor (C3c and C3d) were measured in five patients before, during and after cardiopulmonary bypass. In all patients, C3d concentrations increased significantly in samples obtained after the administration of protamine sulphate. Similarly, circulating C3c was seen only in those samples obtained immediately after protamine admi...
متن کاملUtility of In Vitro Heparin and Protamine Titration for Dosing During Cardiopulmonary Bypass Surgery
Methods used to maintain a hemostatic balance during cardiopulmonary bypass surgery include the optimization of heparin and protamine dosing. Higher heparin doses have been associated with increased bleeding, while other studies have attributed reduced blood loss and transfusion requirements to lower protamine doses. We have evaluated the use of an in vitro heparin and protamine titration syste...
متن کاملCase Reports Factor V Leiden and Cardiopulmonary Bypass
We present a case of a patient with factor V Leiden with an antithrombin III activity of 67%who received a successful aortic valve replacement supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation was achieved by monitoring activated clotting time (ACT) and heparin concentration ensuring adequate anticoagulation throughout the procedure. Results fromACT, heparin dose respon...
متن کاملHigh incidence of antibodies to protamine and protamine/heparin complexes in patients undergoing cardiopulmonary bypass.
Protamine is routinely used to reverse heparin anticoagulation during cardiopulmonary bypass (CPB). Heparin interacts with protamine to form ultralarge complexes that are immunogenic in mice. We hypothesized that patients exposed to protamine and heparin during CPB will develop antibodies (Abs) to protamine/heparin (PRT/H) complexes that are capable of platelet activation. Specimens from a rece...
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