Can protamine be used during perfusion with heparin surface coated equipment?

Details

Serval ID
serval:BIB_DAD3435BA413
Type
Article: article from journal or magazin.
Collection
Publications
Title
Can protamine be used during perfusion with heparin surface coated equipment?
Journal
ASAIO Journal
Author(s)
von Segesser  L. K., Gyurech  D. D., Schilling  J. J., Marquardt  K., Turina  M. I.
ISSN
1058-2916
Publication state
Published
Issued date
09/1993
Peer-reviewed
Oui
Volume
39
Number
3
Pages
M190-4
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jul-Sep
Abstract
Left heart bypass (LHBP) with heparin coated perfusion equipment including an arterial filter (pore size: 40 microns) was performed in five canine experiments after full systemic heparinization (heparin 300 IU/kg; activated coagulation time [ACT] > 480 sec). The heparin coated filter was replaced after 45 min with a second heparin coated filter. Protamine (1:1) was added after 45 min and perfusion was continued for another 45 min before the second filter was replaced with an uncoated control filter. In addition to continuous hemodynamic monitoring, all filters were disassembled and analyzed morphometrically with a scanning electron microscope (deposits on screens were expressed as percent of surface covered with fibrin or number of cells/100 micron 2, respectively). For the first heparin coated filter (ACT > 480), 0.3 +/- 0.5% of the surface was covered with fibrin, 0.7 +/- 0.7% with platelets, and 0.02 +/- 0.0% with red cells. For the second heparin coated filter exposed to neutralization of heparin with protamine, surface coverage was fibrin in 22 +/- 15%, platelets in 3.2 +/- 0.8%, and red cells in 0.2 +/- 0.1% (p < 0.05 for all comparisons with filter 1). For uncoated control filters (ACT = 120), surface coverage was fibrin in 31 +/- 33%, platelets in 3.7 +/- 2.9%, and red cells in 0.2 +/- 0.1% (not significant [NS] for all comparisons with filter 2). Although all arterial filters used in this study remained patent throughout the scheduled period, it became clear that protamine given during perfusion reduces the antithrombotic activity of bonded heparin. Hence, protaminization during perfusion with heparin coated equipment cannot be recommended.
Keywords
Animals Dogs Drug Interactions Equipment Design Erythrocyte Aggregation/drug effects Fibrin/ultrastructure *Heart-Assist Devices Hemofiltration/*instrumentation Heparin/pharmacokinetics/*pharmacology Microscopy, Electron, Scanning Platelet Aggregation/drug effects Protamines/*pharmacology Surface Properties Thrombosis/*blood/prevention & control
Pubmed
Create date
14/02/2008 15:19
Last modification date
03/03/2018 21:55
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