In Vivo Protamine Titration Using Activated Coagulation Time to Neutralize Heparin Anticoagulation in Cardiac Surgery: Proof of Concept

2020 ◽  
Vol 34 (9) ◽  
pp. 2369-2374
Author(s):  
Antoine G. Rochon ◽  
Sylvain Bélisle ◽  
Pierre Couture ◽  
Annik Fortier ◽  
Jean-Sébastien Lebon ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Proof Of Concept ◽  
Coagulation Time ◽  
Heparin Anticoagulation ◽  
Activated Coagulation Time

The Effect of Lysed Platelets on Neutralization of Heparin In Vitro with Protamine as Measured by the Activated Coagulation Time (ACT)

1991 ◽  
Vol 66 (02) ◽  
pp. 213-217 ◽  
Author(s):  
Arthur P Bode ◽  
William J Castellani ◽  
Edna D Hodges ◽  
Susan Yelverton
Keyword(s):  
Platelet Rich Plasma ◽  
Coagulation Time ◽  
Platelet Factor ◽  
Platelet Suspension ◽  
Antiheparin Activity ◽  
Unit Increase ◽  
Heparin Anticoagulation ◽  
Heparin Activity ◽  
Activated Coagulation Time

SummaryThe effect of lysed platelets on the activated coagulation time (ACT) was studied in heparinized whole blood during titration with protamine. Frozen-thawed washed platelet suspension, or a chromatography fraction thereof, or autologous frozen-thawed platelet-rich plasma was added in various dilutions to freshly drawn blood anticoagulated with 3,000 USP units/1 heparin. After a 10 min incubation, the amount of protamine needed to restore the ACT to baseline ("protamine titration dose") was determined. We found that the protamine titration dose decreased in proportion to the amount of lysed platelet material added; expressed as a percentage of the total number of platelets present, each unit increase in lysed platelets produced a 1.7% ±0.8 (SD) reduction in the protamine dose needed to normalize the ACT. A heparin activity assay showed that this effect was not due to antiheparin activity of lysed platelets such as platelet factor 4 (PF4). Our data indicate that the procoagulant activity of platelet membranes reduced the sensitivity of the ACT to heparin. These findings suggest that membranous platelet microparticles may cause an inaccurate calculation, based on the ACT, of a protamine dose to reverse heparin anticoagulation in cardiopulmonary bypass procedures.

Use of Activated Coagulation Time to Monitor Heparin during Cardiac Surgery

1979 ◽  
Vol 28 (1) ◽  
pp. 69-72 ◽  
Author(s):  
Jack A. Roth ◽  
Ramon A. Cukingnan ◽  
Calvin R. Scott
Keyword(s):  
Cardiac Surgery ◽  
Coagulation Time ◽  
Activated Coagulation Time

Arterial versus venous sampling for activated coagulation time measurements during cardiac surgery: A comparative study

2004 ◽  
Vol 18 (5) ◽  
pp. 573-580 ◽  
Author(s):  
Galina Leyvi ◽  
Ilya Zhuravlev ◽  
Asuquo Inyang ◽  
Joselito Vinluan ◽  
Sujatha Ramachandran ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Comparative Study ◽  
Venous Sampling ◽  
Coagulation Time ◽  
Activated Coagulation Time

A Comparison of Activated Coagulation Time–Based Techniques for Anticoagulation During Cardiac Surgery With Cardiopulmonary Bypass

2008 ◽  
Vol 22 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Robert D. Slight ◽  
Rivan Buell ◽  
Onyekwelu C. Nzewi ◽  
David B.L. McClelland ◽  
Pankaj S. Mankad
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Coagulation Time ◽  
Activated Coagulation Time
Sign in / Sign up

Export Citation Format

Share Document