Increased accuracy in heparin and protamine administration decreases bleeding: A pilot study

Journal of Extra-Corporeal Technology

Volumn 41, Issue 1, 2009, Pages 10-14

  Runge, Marx ^a   Møller, Christian H ^a   Steinbrüchel, Daniel A ^a  

^a University of Copenhagen   (Denmark)

Author keywords

Anticoagulation; Extracorporeal circulation; Hemochron RxDx

Indexed keywords

HEPARIN; PROTAMINE; HEPARIN ANTAGONIST;

ACCURACY; ADULT; AGED; ANALYZER; ANTICOAGULANT THERAPY; AORTA VALVE REPLACEMENT; BLOOD CLOTTING TIME; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; CONFERENCE PAPER; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; DOSAGE SCHEDULE COMPARISON; DRUG DOSAGE FORM COMPARISON; DRUG DOSE REDUCTION; DRUG MONITORING; DRUG RESPONSE; FEMALE; HUMAN; IN VITRO STUDY; MAJOR CLINICAL STUDY; MALE; MITRAL VALVE REPLACEMENT; PILOT STUDY; POSTOPERATIVE HEMORRHAGE; PROSPECTIVE STUDY; ALLOTRANSPLANTATION; ARTICLE; COMPARATIVE STUDY; MIDDLE AGED; THORAX SURGERY; THROMBOCYTE AGGREGATION;

AGED; AGED, 80 AND OVER; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; FEMALE; HEPARIN; HEPARIN ANTAGONISTS; HUMANS; MALE; MIDDLE AGED; PILOT PROJECTS; PLATELET AGGREGATION; POSTOPERATIVE HEMORRHAGE; PROSPECTIVE STUDIES; PROTAMINES; THORACIC SURGERY; TRANSPLANTATION, HOMOLOGOUS;

EID: 68549083588     PISSN: 00221058     EISSN: 29698960     Source Type: Journal    
DOI: None     Document Type: Conference Paper

References (19)

1. Paparella D, Brister SJ, Buchanan MR. Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med. 2004;30:1873-81.
2. Karkouti K, Wijeysundera DN, Yau TM, et al. The independent association of massive blood loss with mortality in cardiac surgery. Transfusion. 2004;44:1453-62. (Pubitemid 39318980)
3. Shore-lesserson L, Gravlee GP. Anticoagulation in cardiopulmonary bypass. In: Gravlee GP, Davies R, Kurusz M, Utley JR, eds. Cardiopulmonary Bypass: Principles and Practice. Philadelphia: Lippincott Williams & Wilkins; 2000; 435-72.
4. Ammar T, Fisher CF. The effects of heparinase 1 and protamine on platelet reactivity. Anesthesiology. 1997;86:1382-6.
5. Pretorius M, Scholl FG, McFarlane JA, Murphey LJ, Brown NJ. A pilot study indicating that bradykinin B-2 receptor antagonism attenuates protamine-related hypotension after cardiopulmonary bypass. Clin Pharmacol Ther. 2005;78:477-85.
6. Miyashita T, Nakajima T, Hayashi Y, Kuro M. Hemostatic effects of low-dose protamine following cardiopulmonary bypass. Am J Hematol. 2000;64:112-5.
7. Shore-Lesserson L, Reich DL, DePerio M. Heparin and protamine titration do not improve haemostasis in cardiac surgical patients. Can J Anaesth. 1998;45:10-8. (Pubitemid 28135229)
8. Bull BS, Huse WM, Brauer FS, Korpman RA. Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage. J Thorac Cardiovasc Surg. 1975;69:685-9.
9. Samolyk KA, Beckmann SR, Bissinger RC. A new practical technique to reduce allogeneic blood exposure and hospital costs while preserving clotting factors after cardiopulmonary bypass: The Hemobag. Perfusion. 2005;20:343-9.
10. Freedman J, Luke K, Monga N, et al. A provincial program of blood conservation: The Ontario Transfusion Coordinators (ONTraC). Transfus Apheresis Sci. 2005;33:343-9. (Pubitemid 41586202)
11. Litmathe J, Boeken U, Feindt P, Gams E. Predictors of homologous blood transfusion for patients undergoing open heart surgery. Thorac Cardiovasc Surg. 2003;51:17-21.
12. Casati V, Guzzon D, Oppizzi M, et al. Hemostatic effects of aprotinin, tranexamic acid and epsilon-aminocaproic acid in primary cardiac surgery. Ann Thorac Surg. 1999;68:2252-6. (Pubitemid 30027859)
13. Jobes DR, Aitken GL, Shaffer GW. Increased accuracy and precision of heparin and protamine dosing reduces blood loss and transfusion in patients undergoing primary cardiac operations. J Thorac Cardiovasc Surg. 1995;110:36-45.
14. Koster A, Fischer T, Praus M, et al. Hemostatic activation and inflammatory response during cardiopulmonary bypass: impact of heparin management. Anesthesiology. 2002;97:837-41.
15. Despotis GJ, Joist JH, Hogue CW Jr, et al. The impact of heparin concentration and activated clotting time monitoring on blood conservation. A prospective, randomized evaluation in patients undergoing cardiac operation. J Thorac Cardiovasc Surg. 1995;110:46-54.
16. DeLaria GA, Tyner JJ, Hayes CL, Armstrong BW. Heparin-protamine mismatch. A controllable factor in bleeding after open heart surgery. Arch Surg. 1994;129:944-50.
17. Mejak BL, Stammers A, Rauch E, Vang S, Viessman T. A retrospective study on perfusion incidents and safety devices. Perfusion. 2000;15:51-61. (Pubitemid 30064116)
18. Charriere JM, Pelissie J, Verd C, et al. Survey: Retrospective survey of monitoring/safety devices and incidents of cardiopulmonary bypass for cardiac surgery in France. J Extra Corpor Technol. 2007;39:142-57.
19. Jenkins OF, Morris R, Simpson JM. Australasian perfusion incident survey. Perfusion. 1997;12:279-88.