Why the study?
Considerable controversy persists regarding protamine dosing regimens after cessation of cardiopulmonary bypass, prompting a review of current thinking.
This review highlights the ongoing controversy and current thinking regarding optimal protamine dosing regimens for heparin reversal after cardiopulmonary bypass.
Clinicians face ongoing uncertainty in protamine dosing after CPB; leaves open optimal regimens pending prospective trials.
Without anticoagulation, cardiopulmonary bypass would not have developed over the last nearly 60 years into one of the most influential innovations in medicine; without the ability to reverse anticoagulation, cardiac surgery might not have become the common intervention, which is now practiced globally. Despite the recent breathtaking developments in extracorporeal technology, heparin and protamine remain the pillars of anticoagulation and its reversal until this day. However, there is still much controversy in particular about protamine dosing regimens. A number of recent publications investigating various approaches to dosing protamine have rekindled this debate. This review is seeking to capture the current thinking about protamine dosing after cessation of cardiopulmonary bypass.
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Hecht et al. (2020) studied this question.
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