Clinical study of heparin protamine anticoagulant regimen optimization in patients undergoing cardiac surgery / 实用医学杂志

ABSTRACT

Objective To compare the effect of heparin protamine double titration with traditional meth-ods on postoperative bleeding in patients underwent cardiopulmonary bypass(CPB). Methods Ninety adult patients scheduled to elective CPB by open heart surgery were randomly divided into three groups. In the Conven-tional Group(group A,n=30),375 U/kg heparin was administered.The amount of protamine was in proportion to 125 U1.2 mg base on the initial heparin dose.In the Heparin Titration Group(group B,n=30),heparin was given according to the effect of heparin titration. In the Heparin and Protamine Double Titration Group(group C, n = 30),heparin titration combined with protamine titration were administered. The general data of the patients were recorded. The blood transfusion volume during and after operation,volume of thoracic drainage within 24 hours after operation,operative complications were compared among the 3 groups. Results Group B and group C heparin dosage were less than the group A(P<0.05).The protamine dosage in group C was less than that in group A and group B(P < 0.05). The thoracic drainage volume within 24 hours after operation was higher in the group A than group B and group C(P < 0.05). Conclusion Compared the traditional anticoagulation with heparin and protamine double titration,the latter individualized anticoagulation can reduce the amount of bleeding after CPB.