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Ann Thorac Surg 1977;23:514-519
© 1977 The Society of Thoracic Surgeons

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Articles

Polybrene Neutralization as a Means of Monitoring Heparin Therapy for Extracorporeal Circulation

From the Department of Cardiothoracic Surgery and Hematology, Boston University Medical Center, Boston, and the United States Naval Blood Research Laboratory, Chelsea, MA

Accepted for publication December 13, 1976.

^* Address reprint requests to Dr. Foster, Division of Cardiothoracic Surgery, Suite ME 622, Albany Medical College, Albany, NY 12208

Dose-response effects of heparin and protamine in 34 adult patients undergoing cardiac operations were monitored by an in vitro analysis utilizing hexadimetharine bromide (Polybrene) neutralization. Heparin administered prior to cannulation for cardiopulmonary bypass in a dose of 3.0 mg (300 units) per kilogram of body weight, and 1.5 mg (150 units) per kilogram for each subsequent hour of bypass, routinely produced circulating heparin concentrations greater than 1.0 units per milliliter of plasma. A protamine dose equal to 80% of the total number of milligrams of heparin given resulted in no detectable plasma heparin in 23 of the 34 patients one-half hour after administration. No patient required protamine in an amount greater than the total number of milligrams in the heparin dose to achieve heparin neutralization.

Modest postoperative chest tube drainage (mean, 784 ml in 48 hours) in these patients provides clinical support for low-dose protamine administration for heparin neutralization at the conclusion of cardiopulmonary bypass.

This article has been cited by other articles:

				C. Aren Review article : Heparin and protamine during cardiac surgery Perfusion, July 1, 1989; 4(3): 171 - 181. [PDF]

				J. A. Young, C. T. Kisker, and D. B. Doty Adequate Anticoagulation During Cardiopulmonary Bypass Determined by Activated Clotting Time and the Appearance of Fibrin Monomer Ann. Thorac. Surg., September 1, 1978; 26(3): 231 - 240. [Abstract] [PDF]