| Appropriate Protamine Administration
to Neutralize Heparin after Cardiopulmonary Bypass Using the
Hepcon®/HMS |
(Department of Thoracic Surgery, Hirakata City Hospital,
Hirakata, Japan and Department of Thoracic and Cardiovascular
Surgery, Osaka Medical College*, Takatsuki, Japan)
| Nanritsu Matsuyama |
Kunio Asada* |
Keiichiro Kondo* |
| Toshihiro Kodama |
Shigeto Hasegawa* |
Yoshihide Sawada* |
| Atsushi Yuda* |
Masayoshi Nishimoto* |
Shinjiro Sasaki* |
|
We reevaluated our heparin and protamine
administration protocol during and after cardiopulmonary bypass
(CPB). In 12 patients who underwent cardiac surgery using a heparin-coated
circuit under mild hypothermia, heparin concentration was measured
with the Hepcon®/HMS. Before initiating CPB, 1.5mg/kg of heparin
was given to maintain the activated clotting time (ACT) at more
than 400 sec. Patients were divided into two groups. In group
I (n6), heparin was neutralized with an empirical dose
of protamine (1.5mg protamine/mg initial heparin). In group II
(n6), the protamine dose was determined by the residual
heparin concentration, measured with the Hepcon®. Patients in
group II received a lower dosage of protamine than group I (1.7}0.0
vs. 3.6}0.4mg/kg, p0.001). There were no significant
differences in the intraoperative bleeding, postoperative bleeding
and activated clotting time between the groups. By determining
the appropriate protamine dosage, this heparin analysis system
may be useful in managing CPB.
@Jpn. J. Cardiovasc. Surg. 30: 115-117(2001) |
|
