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Ann Thorac Surg 2001;71:927-928
© 2001 The Society of Thoracic Surgeons

Invited commentary

Wulf Dietrich, MD, PhDa

a Department of Anesthesiology, German Heart Center Munich, Lazarettstrasse 36, D-80636 Munich, Germany

e-mail: dietrich@dhu.mhu.de

Codispoti and colleagues described the use of individualized heparin and protamine management in pediatric patients undergoing cardiac surgery. The authors investigated 26 infants and children being operated for repair of congenital cardiac defects with the use of CPB. In half of the patients heparin management was guided by an individualized and integrated management of anticoagulation (Hepcon HMS), in the other 12 patients standard doses of heparin were applied. The heparin dosage was significantly higher in the study group (891 ± 108 vs 311 ± 5 U/kg) while the protamine dosage necessary for complete heparin antagonization could be dramatically reduced by individualized titration (2.9 ± 0.2 vs 8.6 ± 1.4 mg/kg). Patients in the control group received an extremely high dose of protamine. On the other hand, as stated, the ACT never fell below the limit of . . . [Full Text of this Article]


Related Article

Individualized heparin and protamine management in infants and children undergoing cardiac operations
Massimiliano Codispoti, Christopher A. Ludlam, David Simpson, and Pankaj S. Mankad
Ann. Thorac. Surg. 2001 71: 922-927. [Abstract] [Full Text] [PDF]





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