Anaes SAQs · Cardiac anaesthesia & cardiopulmonary bypass
The anticoagulation — the heparin and the protamine
Primary — the heparin 300-400 U/kg, the ACT above 400 s; the protamine 1-1.3 mg per 100 U heparin; the protamine reactions (hypotension, pulmonary hypertension, anaphylaxis); the alternatives (bivalirudin for HIT).
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Target exams
ANZCAFRCAABAEDAIC
Prompt
Describe the anticoagulation for the CPB (the heparin), the monitoring (the ACT), and the reversal (the protamine) and its adverse reactions.
Question
Describe the anticoagulation for the CPB (the heparin), the monitoring (the ACT), and the reversal (the protamine) and its adverse reactions.
References2ShowHide
- [3]Levy JH, et al. What's fishy about protamine? Clinical use, adverse reactions, alternatives. J Thromb Haemost, 2023.PMID 37062523
- [37062524]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.