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, most of which are based upon the patient's weight or surface area. The sense of security during these procedures was heightened by the fact that serious errors in the control of heparin therapy could occur without any immediate clinical evidence.