Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue
- Author:
Min Jung KU
1
,
2
;
Su Wan KIM
;
Seogjae LEE
;
Jee Won CHANG
;
Jonggeun LEE
Author Information
- Publication Type:Clinical Research
- From:The Korean Journal of Thoracic and Cardiovascular Surgery 2020;53(5):258-262
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass.
Methods:Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31).
Results:Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26°C were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A.
Conclusion:Surgeons’ efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.
