Cardiothoracic & vascular anesthesia
Heparin Activity Following Titration-Guided Protamine Reversal After Cardiopulmonary Bypass: Impact on Postoperative Bleeding
Authors' conclusion
Residual heparin activity was common after low-dose, titration-guided protamine reversal and related to P/H ratio on ICU arrival. Reappearing heparin activity occurred independently of protamine dosing and was not associated with bleeding.
Study context
- Population
- Adults undergoing elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB), heparin and protamine dosing guided by an automated titration system
- Participants
- 40 adults
- Outcome
- Residual heparin activity (anti-FXa)
- Follow-up
- ICU arrival (82 ± 23 minutes after protamine)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Anti-FXa activity, U/mL (mean ± SD)
- 0.14 ± 0.15
- Patients with detectable anti-factor Xa (anti-FXa)
- 60%
- Mean protamine to heparin (P/H) ratio, mg/100 U
- 0.54 ± 0.14
- P/H ratio vs thrombin time (TT), r
- −0.48 (p = 0.004)
- P/H ratio vs activated partial thromboplastin time (aPTT), r
- −0.50 (p = 0.0015)
- P/H ratio vs endogenous thrombin potential, r
- 0.41 (p = 0.0012)
Observational data: associations, not effects.
Further findings
Reappearing heparin activity (anti-FXa) · 3 hours after intensive care unit (ICU) arrival
- Anti-FXa activity increased, U/mL (mean ± SD)
- 0.18 ± 0.10
- Patients with detectable anti-FXa
- 98%
- Independent of P/H ratio
Safety
- No association between heparin activity and postoperative bleeding
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Heparin Activity Following Titration-Guided Protamine Reversal After Cardiopulmonary Bypass: Impact on Postoperative Bleeding. J Cardiothorac Vasc Anesth. Published 30 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →