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KMID : 1164620200530050258
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Korean Journal of Thoracic and Cardiovascular Surgery
2020 Volume.53 No. 5 p.258 ~ p.262
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Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue
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Ku Min-Jung
Kim Su-Wan
Lee Seog-Jae
Chang Jee-Won
Lee Jong-Geun
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Abstract
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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.
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KEYWORD
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Cardiopulmonary bypass, Coagulation, Heparin, Protamines
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