Heparin Reversal With Two Different Protamine Ratios After Cardiopulmonary By-pass.
Status:
Completed
Trial end date:
2024-04-30
Target enrollment:
Participant gender:
Summary
Protamine is routinely used as a heparin reversal agent in cardiac surgery. However, its use
may be associated with adverse events, while protamine excess may have additional
anti-coagulant affect. Although guidelines advise towards a diminished reversal ratio,
clinical practice remain heterogenic. The purpose of this study is to compare two different
reversal ratios (0.6:1 και 0.8:1) of total heparin regarding the Activated Clotting Time
(ACT), viscoelastic assays (Clot-Pro) and clinical hemorrhage.
A baseline ACT value and Clot Pro tests will be obtained prior to the operation start. After
the initial reversal, ACT, Clot Pro tests will be conducted again. Coagulation factors are
administrated according to Clot Pro results, and in case of ongoing clinical hemorrhage and
any indication of heparin excess in the measured values, another 25mg of protamine is
administrated, while tests are repeated.