Relationship between protamine dosage for reversing heparin effects in cardiopulmonary bypass surgery and hemostatic and metabolic outcomes

[eng] Introduction: Systemic anticoagulation during CPB is achieved with heparin and reversed with protamine, though practices vary. This study examined the impact of two protamine dosing strategies on clinical outcomes. Methods: This retrospective study included 653 patients who m...

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Detalles Bibliográficos
Autores: Amaç, Bişar, Abanoz, Mustafa, Hijazi, Alaa, Engin, Mesut, Göç, Ömer
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de las Islas Baleares
Repositorio:Biblioteca Digital de les Illes Balears
OAI Identifier:medicinaBalear:AJHS_Medicina_Balear_2026v41n1p076
Acceso en línea:http://ibdigital.uib.es/greenstone/sites/oai-site/collect/medicinaBalear/index/assoc/AJHS_Med/icina_Ba/lear_202/6v41n1p0/76.dir/AJHS_Medicina_Balear_2026v41n1p076.pdf
http://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2026v41n1p076
Access Level:acceso abierto
Palabra clave:Cardiopulmonary bypass
Health Sciences
Medicine
Descripción
Sumario:&#091;eng&#093; Introduction: Systemic anticoagulation during CPB is achieved with heparin and reversed with protamine, though practices vary. This study examined the impact of two protamine dosing strategies on clinical outcomes. Methods: This retrospective study included 653 patients who met the inclusion criteria and underwent cardiac surgery with cardiopulmonary bypass. Patients who received 0.6 mg protamine for every 100 units of heparin were defined as Group 1, and patients who received 1.2 mg protamine for every 100 units of heparin were defined as Group 2. Descriptive data, preoperative and postoperative variables of the patients were evaluated. Results: Demographic and descriptive data were similar between groups (p>0.05). The only clinically significant difference between groups was the length of hospital stay (p=0.003). Metabolic data showed that urea and lactate levels were higher in group 1 (p=0.012 and p<0.001, respectively). Other haematological, metabolomic, and clinical data potentially related to the protamine/heparin ratio were similar (p>0.05). Conclusion: Both doses were associated with comparable bleeding and transfusion requirements. However, in our study, the length of hospital stay was longer in the group with the 0.6 mg/100IU heparin ratio. Additionally, postoperative urea and lactate levels were also significantly higher in this group.