Hemostatic effects of low-dose protamine following cardiopulmonary bypass.

Abstract:

:Twenty-eight patients undergoing cardiac surgery were prospectively studied and were assigned to two groups. The patients received 0.8- (Group L) or 2.0-fold (Group H) dose of protamine for the neutralization after cardiopulmonary bypass (CPB) which was determined by Hepcon HMS(R) assay system in which the reagent chamber containing the concentration of protamine that completely neutralized the heparin had the shortest clotting time. Mean dose of protamine was 1.60 +/- 0.50 mg kg(-1) in Group L, and 3.56 +/- 1.48 mg kg(-1), respectively. Activated clotting times (ACT) were comparable between the two groups through this study period. In Group H, platelet counts significantly decreased to 69% of that before protamine administration, and plasma platelet factor 4 level significantly increased to approximate 2-fold of that before protamine administration just after protamine administration, respectively. However, these phenomena were not observed in Group L. In addition, these hemostatic changes occurred transiently just after protamine administration. We conclude that the low-dose protamine may prevent transient platelet depletion following CPB. Low-dose protamine can neutralize anticoagulation effect of heparin sufficiently and may mitigate protamine-induced platelet dysfunction.

journal_name

Am J Hematol

authors

Miyashita T,Nakajima T,Hayashi Y,Kuro M

doi

10.1002/(sici)1096-8652(200006)64:2<112::aid-ajh7>

keywords:

subject

Has Abstract

pub_date

2000-06-01 00:00:00

pages

112-5

issue

2

eissn

0361-8609

issn

1096-8652

pii

10.1002/(SICI)1096-8652(200006)64:2<112::AID-AJH7>

journal_volume

64

pub_type

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