A 0.6-protamine/heparin ratio in cardiac surgery is associated with decreased transfusion of blood products.

Abstract:

OBJECTIVES:In cardiac surgery, adequate heparinization is necessary to prevent thrombus formation in the cardiopulmonary bypass (CPB). To counteract the heparin effect after weaning from CPB, protamine is administered. The optimal protamine/heparin ratio is still unknown. METHODS:In this before-after study, we evaluated the effect of a 0.6/1-protamine/heparin ratio implementation as of May 2017 versus a 0.8/1-protamine/heparin ratio on the 12-h postoperative blood loss and the amount of blood and blood component transfusions (fresh frozen plasma, packed red blood cells, fibrinogen concentrate, platelet concentrate and prothrombin complex concentrate) after cardiac surgery. A total of 2051 patients who underwent cardiac surgery requiring CPB between May 2016 and May 2018 were included. RESULTS:In the 0.6/1-protamine/heparin ratio group, only 28.8% of the patients received blood component transfusion, compared to 37.9% of the patients in the 0.8/1-ratio group (P < 0.001). The median 12-h postoperative blood loss was 230 ml (interquartile range 140-320) in the 0.6/1-ratio group versus 260 ml (interquartile range 155-365) in the 0.8/1-ratio group (P < 0.001). CONCLUSIONS:A 0.6/1-protamine/heparin ratio after weaning from CPB is associated with a significantly reduced 12-h postoperative blood loss and blood components transfusion.

authors

Goedhart ALM,Gerritse BM,Rettig TCD,van Geldorp MWA,Bramer S,van der Meer NJM,Boonman-de Winter LJ,Scohy TV

doi

10.1093/icvts/ivaa109

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

391-397

issue

3

eissn

1569-9293

issn

1569-9285

pii

5867246

journal_volume

31

pub_type

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