COMPARISON OF EMPIRICAL PROOTAINE DOSE STRATEGY WITH CALCULATED DOSE BASED ON HEPARIN DOSE RESPONSE CURVE POST CARDIOPULMONARY BYPASS IN CABG PATIENTS

Authors

  • Jehan Essa Abdel Rahman Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Fakher e Fayaz Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Rashad Siddiqi Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Rehan Masroor Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Rehana Javaid Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Syed Muzaffar Hasan Armed Forces Institute of Cardiology/National Institute of Health Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

Keywords:

ACT, Heparin, On pump CABG, Protamine

Abstract

Objective: To investigate whether calculated Protamine dose can obtain satisfactory post Heparin reversal ACT results and reduce protamine usage compared with traditional empirical full protamine dosage.

Study Design: Randomized controlled trial.

Place and Duration of Study: Armed Forces Institute of Cardiology/NIHD between Nov 2018 and Feb 2019.

Methodology: Peri-operative ACT results of 240 consecutive patients, undergoing on pump coronary artery bypass graft (CABG) surgery were collected, they were randomly divided into two groups A and B, Heparin was reversed by administering a calculated protamine dose based on Heparin dose response curve in group A and full dose Protamine (1mg per 100 IU) in group B. Baseline ACT, total Heparin dose administered, Protamine dose, post Protamine ACT were recorded for all patients.

Results: Post Heparin reversal ACT is returned to near baseline values 107.80 ± 14.471 compared with control ACT 106.90 ± 16.843 (p-value 0.006) in group A patients, and satisfactory ACT 124.10 ± 20.415 levels in patients of group B, but accompanied with significant additional doses of protamine (p-valve 0.02).

Conclusion: Both doses of Protamine whether empirical full dose or based on Heparin Dose response curve provides optimal heparin reversal, while full dose protamine is associated with unnecessary protamine additional doses.

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Published

29-11-2019

How to Cite

Rahman, J. E. A., Fayaz, F. e, Siddiqi, R., Masroor, R., Javaid, R., & Hasan, S. M. (2019). COMPARISON OF EMPIRICAL PROOTAINE DOSE STRATEGY WITH CALCULATED DOSE BASED ON HEPARIN DOSE RESPONSE CURVE POST CARDIOPULMONARY BYPASS IN CABG PATIENTS. Pakistan Armed Forces Medical Journal, 69(Suppl-3), S399–403. Retrieved from https://www.pafmj.org/PAFMJ/article/view/3550

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