Abstract Background One of the challenges during cardiac surgery is to keep patients fully anticoagulated during the time and reversing at the end of surgery. For that purpose, heparin and its approved..
Read More
Abstract BACKGROUND: The standardized management of anticoagulation during the cardiopulmonary bypass seems inaccurate because of patients and surgeries variability. This study evaluates if an individualized management of heparin and protamine..
Read More
Abstract Background The dose of protamine required following cardiopulmonary bypass (CPB) is often determined by the dose of heparin required pre-CPB, expressed as a fixed ratio. Dosing based on mathematical..
Read More
Vanderbilt University Medical Center; Department of CV Surgery: Faculty Forum: Understanding alpha stat and pH stat Faculty: Katie Faella CCP, LCP, FPP, J. Hoffman, MD, Matt Warhoover, CCP, A. Lepore,..
Read More
Abstract Background Recurrent observation of clot in the cardiopulmonary bypass circuit after the administration of a protamine test dose (PTD) prompted concern over the effects of PTDs on patient activated..
Read More
Abstract Coronary artery bypass grafting surgery (CABG) in hemophilia patients is challenging. Thromboelastography (TEG) is useful to assess hemostasis perioperatively. A patient with severe hemophilia A underwent CABG with TEG studies...
Read More
Abstract Introduction: This manuscript represents a pilot study assessing the feasibility of a single-compartment, individualised, pharmacokinetic algorithm for protamine dosing after cardiopulmonary bypass. Methods: A pilot cohort study in a..
Read More
Abstract Objectives: Platelet dysfunction is an important cause of postoperative bleeding after cardiac surgery. Protamine is routinely used for reversal of heparin after cardiopulmonary bypass (CBP), but may affect platelet..
Read More
Abstract The study by Grieshaber and colleagues, “Platelet-activating protamine-heparin-antibodies lead to higher protamine demand in patients undergoing cardiac surgery,” in this issue of the Journal, is a prospective study that joins other..
Read More
Case 1 A 78-year-old male diabetic patient underwent elective coronary artery bypass grafting (CABG). His insulin therapy had been changed recently to human insulin (Humulin M3; Eli Lilly Italia, Sesto..
Read More
Abstract Essentials Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..
Read More
Abstract Objectives The aim of the study was to investigate whether the HeProCalc algorithm affects heparin and dosage, , and transfusion rate. Design Randomized controlled trial. Setting University hospital. Participants The..
Read More
Abstract Essentials Heparin‐protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post‐operative bleeding occurred in 36% and heparin rebound in..
Read More
Abstract Background Protamine neutralization is an essential step for the safe use and inactivation of the unfractionated heparin (UFH) that is widely employed in surgical and non‐surgical procedures involving extracorporeal..
Read More
Abstract Introduction: Accurate dosing of protamine reversal following on-pump cardiac surgical procedures is challenging, with both excessive and inadequate administration recognised to increase bleeding risk. We aimed to examine the..
Read More
Abstract Coagulation Factor XII (fXII), the Hageman factor, is a procoagulant 80kDa glycoprotein with a plasma concentration of about 40 µg/mL (approximately 500 nmol/L). Plasma fXII is mainly synthesized in..
Read More