The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines ∗—Anticoagulation During Cardiopulmonary Bypass

Annals of Thoracic Surgery

Volumn 105, Issue 2, 2018, Pages 650-662

  Shore Lesserson, Linda ^a   Baker, Robert A ^b   Ferraris, Victor A ^c   Greilich, Philip E ^d   Fitzgerald, David ^e   Roman, Philip ^f   Hammon, John W ^g  

^a DONALD AND BARBARA ZUCKER SCHOOL OF MEDICINE AT HOFSTRA NORTHWELL   (United States)

^b FLINDERS MEDICAL CENTRE   (Australia)

^c UNIVERSITY OF KENTUCKY   (United States)

^d UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

^e MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

^f ST ANTHONY HOSPITAL   (United States)

^g WAKE FOREST SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICOAGULANT AGENT; BIVALIRUDIN; HEPARIN; ILOPROST;

AMERICAN; ANESTHESIOLOGIST; ANTICOAGULANT THERAPY; ARTICLE; CARDIOPULMONARY BYPASS; DRUG CONTRAINDICATION; EXTRACORPOREAL CIRCULATION; HEART SURGERY; HUMAN; MEDICAL SOCIETY; META ANALYSIS (TOPIC); MULTICENTER STUDY (TOPIC); NONHUMAN; PEROPERATIVE CARE; PRACTICE GUIDELINE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); SYSTEMATIC REVIEW; THORACIC SURGEON; ANESTHESIOLOGY; CARDIOVASCULAR DISEASE; FIBRINOLYTIC THERAPY; STANDARDS; THORAX SURGERY; UNITED STATES;

ANESTHESIOLOGY; CARDIOPULMONARY BYPASS; CARDIOVASCULAR DISEASES; EXTRACORPOREAL CIRCULATION; HUMANS; INTRAOPERATIVE CARE; PRACTICE GUIDELINES AS TOPIC; SOCIETIES, MEDICAL; THORACIC SURGERY; THROMBOLYTIC THERAPY; UNITED STATES;

EID: 85041124637     PISSN: 00034975     EISSN: 15526259     Source Type: Journal    
DOI: 10.1016/j.athoracsur.2017.09.061     Document Type: Article

References (118)

1. Stoney, W.S., Evolution of cardiopulmonary bypass. Circulation 119 (2009), 2844–2853.
2. Ferraris, V.A., Heroes and evidence. J Thorac Cardiovasc Surg 124 (2002), 11–13.
3. Bull, B.S., Korpman, R.A., Huse, W.M., Briggs, B.D., Heparin therapy during extracorporeal circulation. I. Problems inherent in existing heparin protocols. J Thorac Cardiovasc Surg 69 (1975), 674–684.
4. Young, J.A., Kisker, C.T., Doty, D.B., Adequate anticoagulation during cardiopulmonary bypass determined by activated clotting time and the appearance of fibrin monomer. Ann Thorac Surg 26 (1978), 231–240.
5. Na, S., Stabilized infective endocarditis and altered heparin responsiveness during cardiopulmonary bypass. World J Surg 33 (2009), 1862–1867.
6. Garvin, S., FitzGerald, D.C., Despotis, G., Shekar, P., Body, S.C., Heparin concentration-based anticoagulation for cardiac surgery fails to reliably predict heparin bolus dose requirements. Anesth Analg 111 (2010), 849–855.
7. Grima, C., The effects of intermittent prebypass heparin dosing in patients undergoing coronary artery bypass grafting. Perfusion 18 (2003), 283–289.
8. Neema, P., Sinha, P., Rathod, R., Activated clotting time during cardiopulmonary bypass: is repetition necessary during open heart surgery?. Asian Cardiovasc Thorac Ann 12 (2004), 47–52.
9. Shore-Lesserson, L., Evidence based coagulation monitors: heparin monitoring, thromboelastography, and platelet function. Semin Cardiothorac Vasc Anesth 9 (2005), 41–52.
10. Machin, D., Devine, P., The effect of temperature and aprotinin during cardiopulmonary bypass on three different methods of activated clotting time measurement. J Extra Corpor Technol 37 (2005), 265–271.
11. Leyvi, G., Shore-Lesserson, L., Harrington, D., Vela-Cantos, F., Hossain, S., An investigation of a new activated clotting time MAX-ACT in patients undergoing extracorporeal circulation. Anesth Analg 92 (2001), 578–583.
12. Koster, A., Fischer, T., Praus, M., et al. Hemostatic activation and inflammatory response during cardiopulmonary bypass: impact of heparin management. Anesthesiology 97 (2002), 837–841.
13. Despotis, G.J., Joist, J.H., Hogue, C.W., 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 110 (1995), 46–54.
14. Despotis, G.J., Joist, J.H., Hogue, C.W., et al. More effective suppression of hemostatic system activation in patients undergoing cardiac surgery by heparin dosing based on heparin blood concentrations rather than ACT. Thromb Haemost 76 (1996), 902–908.
15. Pappalardo, F., Franco, A., Crescenzi, G., De Simone, F., Torracca, L., Zangrillo, A., Anticoagulation management in patients undergoing open heart surgery by activated clotting time and whole blood heparin concentration. Perfusion 21 (2006), 285–290.
16. Hofmann, B., Bushnaq, H., Kraus, F.B., et al. Immediate effects of individualized heparin and protamine management on hemostatic activation and platelet function in adult patients undergoing cardiac surgery with tranexamic acid antifibrinolytic therapy. Perfusion 28 (2013), 412–418.
17. Newsome, J., Stipanovich, K., Flaherty, S., Comparison of heparin administration using the Rapidpoint Coag and Hepcon HMS. J Extra Corpor Technol 36 (2004), 139–144.
18. Hansen, R., Koster, A., Kukucka, M., Mertzlufft, F., Kuppe, H., A quick anti-Xa-activity-based whole blood coagulation assay for monitoring unfractionated heparin during cardiopulmonary bypass: a pilot investigation. Anesth Analg 91 (2000), 533–538.
19. Hellstern, P., Bach, J., Simon, M., Saggau, W., Heparin monitoring during cardiopulmonary bypass surgery using the one-step point-of-care whole blood anti-factor-Xa clotting assay Heptest-POC-Hi. J Extra Corpor Technol 39 (2007), 81–86.
20. Gravlee, G.P., Haddon, W.S., Rothberger, H.K., et al. Heparin dosing and monitoring for cardiopulmonary bypass. A comparison of techniques with measurement of subclinical plasma coagulation. J Thorac Cardiovasc Surg 99 (1990), 518–527.
21. Gravlee, G.P., Rogers, A.T., Dudas, L.M., et al. Heparin management protocol for cardiopulmonary bypass influences postoperative heparin rebound but not bleeding. Anesthesiology 76 (1992), 393–401.
22. Ichikawa, J., Kodaka, M., Nishiyama, K., Hirasaki, Y., Ozaki, M., Komori, M., Reappearance of circulating heparin in whole blood heparin concentration-based management does not correlate with postoperative bleeding after cardiac surgery. J Cardiothorac Vasc Anesth 28 (2014), 1015–1019.
23. Bosch, Y.P., Ganushchak, Y.M., de Jong, D.S., Comparison of ACT point-of-care measurements: repeatability and agreement. Perfusion 21 (2006), 27–31.
24. Wallock, M., Jeske, W.P., Bakhos, M., Walenga, J.M., Evaluation of a new point of care heparin test for cardiopulmonary bypass: the TAS heparin management test. Perfusion 16 (2001), 147–153.
25. Leyvi, G., Zhuravlev, I., Inyang, A., et al. Arterial versus venous sampling for activated coagulation time measurements during cardiac surgery: a comparative study. J Cardiothorac Vasc Anesth 18 (2004), 573–580.
26. Searles, B., Nasrallah, F., Darling, E., Yarcusko, S., How does the age of a blood sample affect its activated clotting time? Comparison of eight different devices. J Extra Corpor Technol 34 (2002), 175–177.
27. Welsby, I.J., McDonnell, E., El-Moalem, H., Stafford-Smith, M., Toffaletti, J.G., Activated clotting time systems vary in precision and bias and are not interchangeable when following heparin management protocols during cardiopulmonary bypass. J Clin Monit Comput 17 (2002), 287–292.
28. Raymond, P.D., Ray, M.J., Callen, S.N., Marsh, N.A., Heparin monitoring during cardiac surgery. Part 2: calculating the overestimation of heparin by the activated clotting time. Perfusion 18 (2003), 277–281.
29. Patteril, M., Stafford-Smith, M., Toffaletti, J.G., Bute, B.P., Milano, C.A., Welsby, I.J., Changing systems for measuring activated clotting times: impact on the clinical practice of heparin anticoagulation during cardiac surgery. Clin Chim Acta 356 (2005), 218–224.
30. Chavez, J.J., Foley, D.E., Snider, C.C., et al. A novel thrombelastograph tissue factor/kaolin assay of activated clotting times for monitoring heparin anticoagulation during cardiopulmonary bypass. Anesth Analg 99 (2004), 1290–1294.
31. Ganter, M.T., Monn, A., Tavakoli, R., et al. Monitoring activated clotting time for combined heparin and aprotinin application: in vivo evaluation of a new aprotinin-insensitive test using Sonoclot. Eur J Cardiothorac Surg 30 (2006), 278–284.
32. Ganter, M.T., Monn, A., Tavakoli, R., Klaghofer, R., Zollinger, A., Hofer, C.K., Kaolin-based activated coagulation time measured by Sonoclot in patients undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth 21 (2007), 524–528.
33. Watson, H., Davidson, S., Keeling, D., Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology. Guidelines on the diagnosis and management of heparin-induced thrombocytopenia: second edition. Br J Haematol 159 (2012), 528–540.
34. Prechel, M.M., Walenga, J.M., Emphasis on the role of PF4 in the incidence, pathophysiology and treatment of heparin induced thrombocytopenia. Thromb J, 11, 2013, 7.
35. Bircher, A.J., Harr, T., Hohenstein, L., Tsakiris, D.A., Hypersensitivity reactions to anticoagulant drugs: diagnosis and management options. Allergy 61 (2006), 1432–1440.
36. Centers for Disease Control. Acute allergic-type reactions among patients undergoing hemodialysis—multiple states, 2007–2008. MMWR Morb Mortal Wkly Rep 57 (2008), 124–125.
37. Greinacher, A., Heparin-induced thrombocytopenia. N Engl J Med 373 (2015), 252–261.
38. Warkentin, T.E., Clinical picture of heparin-induced thrombocytopenia (HIT) and its differentiation from non-HIT thrombocytopenia. Thromb Haemost 116 (2016), 813–822.
39. Kerendi, F., Thourani, V.H., Puskas, J.D., et al. Impact of heparin-induced thrombocytopenia on postoperative outcomes after cardiac surgery. Ann Thorac Surg 84 (2007), 1548–1555.
40. Bennett-Guerrero, E., Slaughter, T.F., White, W.D., et al. Preoperative anti-PF4/heparin antibody level predicts adverse outcome after cardiac surgery. J Thorac Cardiovasc Surg 130 (2005), 1567–1572.
41. Kress, D.C., Aronson, S., McDonald, M.L., et al. Positive heparin-platelet factor 4 antibody complex and cardiac surgical outcomes. Ann Thorac Surg 83 (2007), 1737–1743.
42. Stribling, W.K., Slaughter, T.F., Houle, T.T., Sane, D.C., Beyond the platelet count: heparin antibodies as independent risk predictors. Am Heart J 153 (2007), 900–906.
43. Linkins, L.A., Dans, A.L., Moores, L.K., et al. Treatment and prevention of heparin-induced thrombocytopenia: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 141:Suppl (2012), e495–e530.
44. Selleng, S., Haneya, A., Hirt, S., Selleng, K., Schmid, C., Greinacher, A., Management of anticoagulation in patients with subacute heparin-induced thrombocytopenia scheduled for heart transplantation. Blood 112 (2008), 4024–4027.
45. Warkentin, T.E., Sheppard, J.A., Serological investigation of patients with a previous history of heparin-induced thrombocytopenia who are reexposed to heparin. Blood 123 (2014), 2485–2493.
46. Warkentin, T.E., Greinacher, A., Koster, A., Lincoff, A.M., Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 133:Suppl (2008), 340–380.
47. Lubenow, N., Kempf, R., Eichner, A., Eichler, P., Carlsson, L.E., Greinacher, A., Heparin-induced thrombocytopenia: temporal pattern of thrombocytopenia in relation to initial use or reexposure to heparin. Chest 122 (2002), 37–42.
48. Warkentin, T.E., Kelton, J.G., A 14-year study of heparin-induced thrombocytopenia. Am J Med 101 (1996), 502–507.
49. Nuttall, G.A., Oliver, W.C., Santrach, P.J., et al. Patients with a history of type II heparin-induced thrombocytopenia with thrombosis requiring cardiac surgery with cardiopulmonary bypass: a prospective observational case series. Anesth Analg 96 (2003), 344–350.
50. Potzsch, B., Klovekorn, W.P., Madlener, K., Use of heparin during cardiopulmonary bypass in patients with a history of heparin-induced thrombocytopenia. N Engl J Med, 343, 2000, 515.
51. Warkentin, T.E., Arnold, D.M., Nazi, I., Kelton, J.G., The platelet serotonin-release assay. Am J Hematol 90 (2015), 564–572.
52. Warkentin, T.E., Heparin-induced thrombocytopenia in critically ill patients. Semin Thromb Hemost 41 (2015), 49–60.
53. Piednoir, P., Allou, N., Provenchere, S., et al. Heparin-induced thrombocytopenia after cardiac surgery: an observational study of 1,722 patients. J Cardiothorac Vasc Anesth 26 (2012), 585–590.
54. Lo, G.K., Juhl, D., Warkentin, T.E., Sigouin, C.S., Eichler, P., Greinacher, A., Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost 4 (2006), 759–765.
55. Lillo-Le Louet, A., Boutouyrie, P., Alhenc-Gelas, M., et al. Diagnostic score for heparin-induced thrombocytopenia after cardiopulmonary bypass. J Thromb Haemost 2 (2004), 1882–1888.
56. Cuker, A., Arepally, G., Crowther, M.A., et al. The HIT expert probability (HEP) score: a novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion. J Thromb Haemost 8 (2010), 2642–2650.
57. Cuker, A., Gimotty, P.A., Crowther, M.A., Warkentin, T.E., Predictive value of the 4Ts scoring system for heparin-induced thrombocytopenia: a systematic review and meta-analysis. Blood 120 (2012), 4160–4167.
58. Warkentin, T.E., Kelton, J.G., Temporal aspects of heparin-induced thrombocytopenia. N Engl J Med 344 (2001), 1286–1292.
59. Warkentin, T.E., Sheppard, J.A., Horsewood, P., Simpson, P.J., Moore, J.C., Kelton, J.G., Impact of the patient population on the risk for heparin-induced thrombocytopenia. Blood 96 (2000), 1703–1708.
60. Pouplard, C., May, M.A., Regina, S., Marchand, M., Fusciardi, J., Gruel, Y., Changes in platelet count after cardiac surgery can effectively predict the development of pathogenic heparin-dependent antibodies. Br J Haematol 128 (2005), 837–841.
61. Warkentin, T.E., Greinacher, A., Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:Suppl (2004), 311–337.
62. Berkun, Y., Haviv, Y.S., Schwartz, L.B., Shalit, M., Heparin-induced recurrent anaphylaxis. Clin Exp Allergy 34 (2004), 1916–1918.
63. Grims, R.H., Weger, W., Reiter, H., Arbab, E., Kranke, B., Aberer, W., Delayed-type hypersensitivity to low molecular weight heparins and heparinoids: cross-reactivity does not depend on molecular weight. Br J Dermatol 157 (2007), 514–517.
64. Jappe, U., Allergy to heparins and anticoagulants with a similar pharmacological profile: an update. Blood Coagul Fibrinolysis 17 (2006), 605–613.
65. Koster, A., Spiess, B., Chew, D.P., et al. Effectiveness of bivalirudin as a replacement for heparin during cardiopulmonary bypass in patients undergoing coronary artery bypass grafting. Am J Cardiol 93 (2004), 356–359.
66. Zucker, M.L., Koster, A., Prats, J., Laduca, F.M., Sensitivity of a modified ACT test to levels of bivalirudin used during cardiac surgery. J Extra Corpor Technol 37 (2005), 364–368.
67. Merry, A.F., Focus on thrombin: alternative anticoagulants. Semin Cardiothorac Vasc Anesth 11 (2007), 256–260.
68. Nagle, E.L., Tsu, L.V., Dager, W.E., Bivalirudin for anticoagulation during hypothermic cardiopulmonary bypass and recombinant factor VIIa for iatrogenic coagulopathy. Ann Pharmacother, 45, 2011, e47.
69. Koster, A., Dyke, C.M., Aldea, G., et al. Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies: results of the CHOOSE-ON trial. Ann Thorac Surg 83 (2007), 572–577.
70. Dyke, C.M., Smedira, N.G., Koster, A., et al. A comparison of bivalirudin to heparin with protamine reversal in patients undergoing cardiac surgery with cardiopulmonary bypass: the EVOLUTION-ON study. J Thorac Cardiovasc Surg 131 (2006), 533–539.
71. Stratmann, G., deSilva, A.M., Tseng, E.E., et al. Reversal of direct thrombin inhibition after cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia. Anesth Analg 98 (2004), 1635–1639.
72. Koster, A., Buz, S., Krabatsch, T., et al. Effect of modified ultrafiltration on bivalirudin elimination and postoperative blood loss after on-pump coronary artery bypass grafting: assessment of different filtration strategies. J Card Surg 23 (2008), 655–658.
73. Schwartz, J., Winters, J.L., Padmanabhan, A., et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: the sixth special issue. J Clin Apher 28 (2013), 145–284.
74. Welsby, I.J., Um, J., Milano, C.A., Ortel, T.L., Arepally, G., Plasmapheresis and heparin reexposure as a management strategy for cardiac surgical patients with heparin-induced thrombocytopenia. Anesth Analg 110 (2010), 30–35.
75. Warkentin, T.E., Sheppard, J.A., Chu, F.V., Kapoor, A., Crowther, M.A., Gangji, A., Plasma exchange to remove HIT antibodies: dissociation between enzyme-immunoassay and platelet activation test reactivities. Blood 125 (2015), 195–198.
76. Addonizio, V.P., Fisher, C.A., Kappa, J.R., Ellison, N., Prevention of heparin-induced thrombocytopenia during open heart surgery with iloprost (ZK36374). Surgery 102 (1987), 796–807.
77. Palatianos, G.M., Foroulis, C.N., Vassili, M.I., et al. Preoperative detection and management of immune heparin-induced thrombocytopenia in patients undergoing heart surgery with iloprost. J Thorac Cardiovasc Surg 127 (2004), 548–554.
78. Koster, A., Kukucka, M., Bach, F., et al. Anticoagulation during cardiopulmonary bypass in patients with heparin-induced thrombocytopenia type II and renal impairment using heparin and the platelet glycoprotein IIb-IIIa antagonist tirofiban. Anesthesiology 94 (2001), 245–251.
79. Tanigawa, Y., Yamada, T., Matsumoto, K., Nakagawachi, A., Torikai, A., Sakaguchi, Y., Non-recovery of ACT in a patient with heparin-induced thrombocytopenia type II during mitral valve replacement using argatroban anticoagulation. J Anesth 27 (2013), 951–955.
80. Genzen, J.R., Fareed, J., Hoppensteadt, D., et al. Prolonged elevation of plasma argatroban in a cardiac transplant patient with a suspected history of heparin-induced thrombocytopenia with thrombosis. Transfusion 50 (2010), 801–807.
81. Agarwal, S., Ullom, B., Al-Baghdadi, Y., Okumura, M., Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass. J Anaesthesiol Clin Pharmacol 28 (2012), 106–110.
82. Follis, F., Filippone, G., Montalbano, G., et al. Argatroban as a substitute of heparin during cardiopulmonary bypass: a safe alternative?. Interact Cardiovasc Thorac Surg 10 (2010), 592–596.
83. Murphy, G.S., Marymont, J.H., Alternative anticoagulation management strategies for the patient with heparin-induced thrombocytopenia undergoing cardiac surgery. J Cardiothorac Vasc Anesth 21 (2007), 113–126.
84. Galeone, A., Rotunno, C., Guida, P., et al. Monitoring incomplete heparin reversal and heparin rebound after cardiac surgery. J Cardiothorac Vasc Anesth 27 (2013), 853–858.
85. Murray, D.J., Brosnahan, W.J., Pennell, B., Kapalanski, D., Weiler, J.M., Olson, J., Heparin detection by the activated coagulation time: a comparison of the sensitivity of coagulation tests and heparin assays. J Cardiothorac Vasc Anesth 11 (1997), 24–28.
86. Guo, Y., Tang, J., Du, L., et al. Protamine dosage based on two titrations reduces blood loss after valve replacement surgery: a prospective, double-blinded, randomized study. Can J Cardiol 28 (2012), 547–552.
87. Shigeta, O., Kojima, H., Hiramatsu, Y., et al. Low-dose protamine based on heparin-protamine titration method reduces platelet dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg 118 (1999), 354–360.
88. Runge, M., Moller, C.H., Steinbruchel, D.A., Increased accuracy in heparin and protamine administration decreases bleeding: a pilot study. J Extra Corpor Technol 41 (2009), 10–14.
89. Shore-Lesserson, L., Reich, D.L., DePerio, M., Heparin and protamine titration do not improve haemostasis in cardiac surgical patients. Can J Anaesth 45 (1998), 10–18.
90. Gundry, S.R., Drongowski, R.A., Coran, A.G., Kirsh, M.M., Klein, M.D., Failure of automated protamine titration to determine the protamine reversal dose of systemic heparin: comparison with other methods. Curr Surg 43 (1986), 110–112.
91. Wang, J., Ma, H.P., Zheng, H., Blood loss after cardiopulmonary bypass, standard versus titrated protamine: a meta-analysis. Neth J Med 71 (2013), 123–127.
92. Vonk, A.B., Veerhoek, D., van den Brom, C.E., van Barneveld, L.J., Boer, C., Individualized heparin and protamine management improves rotational thromboelastometric parameters and postoperative hemostasis in valve surgery. J Cardiothorac Vasc Anesth 28 (2014), 235–241.
93. Koster, A., Borgermann, J., Gummert, J., Rudloff, M., Zittermann, A., Schirmer, U., Protamine overdose and its impact on coagulation, bleeding, and transfusions after cardiopulmonary bypass: results of a randomized double-blind controlled pilot study. Clin Appl Thromb Hemost 20 (2014), 290–295.
94. Mochizuki, T., Olson, P.J., Szlam, F., Ramsay, J.G., Levy, J.H., Protamine reversal of heparin affects platelet aggregation and activated clotting time after cardiopulmonary bypass. Anesth Analg 87 (1998), 781–785.
95. Carr, M.E., Carr, S.L., At high heparin concentrations, protamine concentrations which reverse heparin anticoagulant effects are insufficient to reverse heparin anti-platelet effects. Thromb Res 75 (1994), 617–630.
96. Dunning, J., Versteegh, M., Fabbri, A., et al. Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur J Cardiothorac Surg 34 (2008), 73–92.
97. Martin, P., Horkay, F., Gupta, N.K., Gebitekin, C., Walker, D.R., Heparin rebound phenomenon—much ado about nothing?. Blood Coagul Fibrinolysis 3 (1992), 187–191.
98. Taneja, R., Marwaha, G., Sinha, P., et al. Elevated activated partial thromboplastin time does not correlate with heparin rebound following cardiac surgery. Can J Anaesth 56 (2009), 489–496.
99. Teoh, K.H., Young, E., Blackall, M.H., Roberts, R.S., Hirsh, J., Can extra protamine eliminate heparin rebound following cardiopulmonary bypass surgery?. J Thorac Cardiovasc Surg 128 (2004), 211–219.
100. Nybo, M., Madsen, J.S., Serious anaphylactic reactions due to protamine sulfate: a systematic literature review. Basic Clin Pharmacol Toxicol 103 (2008), 192–196.
101. Boigner, H., Lechner, E., Brock, H., Golej, J., Trittenwein, G., Life threatening cardiopulmonary failure in an infant following protamine reversal of heparin after cardiopulmonary bypass. Paediatr Anaesth 11 (2001), 729–732.
102. Kimmel, S.E., Sekeres, M., Berlin, J.A., Ellison, N., Mortality and adverse events after protamine administration in patients undergoing cardiopulmonary bypass. Anesth Analg 94 (2002), 1402–1408.
103. Welsby, I.J., Newman, M.F., Phillips-Bute, B., Messier, R.H., Kakkis, E.D., Stafford-Smith, M., Hemodynamic changes after protamine administration: association with mortality after coronary artery bypass surgery. Anesthesiology 102 (2005), 308–314.
104. Kimmel, S.E., Sekeres, M.A., Berlin, J.A., Goldberg, L.R., Strom, B.L., Adverse events after protamine administration in patients undergoing cardiopulmonary bypass: risks and predictors of under-reporting. J Clin Epidemiol 51 (1998), 1–10.
105. Ford, S.A., Kam, P.C., Baldo, B.A., Fisher, M.M., Anaphylactic or anaphylactoid reactions in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth 15 (2001), 684–688.
106. Viaro, F., Dalio, M.B., Evora, P.R., Catastrophic cardiovascular adverse reactions to protamine are nitric oxide/cyclic guanosine monophosphate dependent and endothelium mediated: should methylene blue be the treatment of choice?. Chest 122 (2002), 1061–1066.
107. Comunale, M.E., Maslow, A., Robertson, L.K., Haering, J.M., Mashikian, J.S., Lowenstein, E., Effect of site of venous protamine administration, previously alleged risk factors, and preoperative use of aspirin on acute protamine-induced pulmonary vasoconstriction. J Cardiothorac Vasc Anesth 17 (2003), 309–313.
108. Ocal, A., Kiris, I., Erdinc, M., Peker, O., Yavuz, T., Ibrisim, E., Efficiency of prostacyclin in the treatment of protamine-mediated right ventricular failure and acute pulmonary hypertension. Tohoku J Exp Med 207 (2005), 51–58.
109. Olinger, G.N., Becker, R.M., Bonchek, L.I., Noncardiogenic pulmonary edema and peripheral vascular collapse following cardiopulmonary bypass: rare protamine reaction?. Ann Thorac Surg 29 (1980), 20–25.
110. Pretorius, M., Scholl, F.G., McFarlane, J.A., Murphey, L.J., Brown, N.J., A pilot study indicating that bradykinin B2 receptor antagonism attenuates protamine-related hypotension after cardiopulmonary bypass. Clin Pharmacol Ther 78 (2005), 477–485.
111. Lee, G.M., Welsby, I.J., Phillips-Bute, B., Ortel, T.L., Arepally, G.M., High incidence of antibodies to protamine and protamine/heparin complexes in patients undergoing cardiopulmonary bypass. Blood 121 (2013), 2828–2835.
112. Bakchoul, T., Zollner, H., Amiral, J., et al. Anti-protamine-heparin antibodies: incidence, clinical relevance, and pathogenesis. Blood 121 (2013), 2821–2827.
113. Vincent, G.M., Janowski, M., Menlove, R., Protamine allergy reactions during cardiac catheterization and cardiac surgery: risk in patients taking protamine-insulin preparations. Cathet Cardiovasc Diagn 23 (1991), 164–168.
114. Bernabei, A., Gikakis, N., Maione, T.E., et al. Reversal of heparin anticoagulation by recombinant platelet factor 4 and protamine sulfate in baboons during cardiopulmonary bypass. J Thorac Cardiovasc Surg 109 (1995), 765–771.
115. Levy, J.H., Cormack, J.G., Morales, A., Heparin neutralization by recombinant platelet factor 4 and protamine. Anesth Analg 81 (1995), 35–37.
116. Demma, L., Levy, J.H., A case series of recombinant platelet factor 4 for heparin reversal after cardiopulmonary bypass. Anesth Analg 115 (2012), 1273–1278.
117. Kikura, M., Lee, M.K., Levy, J.H., Heparin neutralization with methylene blue, hexadimethrine, or vancomycin after cardiopulmonary bypass. Anesth Analg 83 (1996), 223–227.
118. Stafford-Smith, M., Lefrak, E.A., Qazi, A.G., et al. Efficacy and safety of heparinase I versus protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass. Anesthesiology 103 (2005), 229–240.