Open AccessLess is more: We are administering too much protamine in cardiac surgery
Author(s) -
Francesco De Simone,
Pasquale Nardelli,
Margherita Licheri,
Giovanna Frau,
Martina Baiardo Redaelli,
Fabrizio Monaco,
Alberto Zangrillo,
Giovanni Landoni
Publication year - 2021
Publication title -
annals of cardiac anaesthesia/annals of cardiac anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.42
H-Index - 27
eISSN - 0974-5181
pISSN - 0971-9784
DOI - 10.4103/aca.aca_26_19
Subject(s) - protamine , heparin , medicine , cardiopulmonary bypass , activated clotting time , cardiac surgery , anesthesia , hemostasis , cardiology
Protamine is routinely administered to neutralize the anticlotting effects of heparin, traditionally at a dose of 1 mg for every 100 IU of heparin-a 1:1 ratio protamine sparing effects-but this is based more on experience and practice than literature evidence. The use of Hemostasis Management System (HMS) allows an individualized heparin and protamine titration. This usually results in a decreased protamine dose, thus limiting its side effects, including paradox anticoagulation.