Exact heparin level in blood – novel light-scattering analysis makes the intraoperative direct determination possible

Abstract

Aims: Current anticoagulation management in cardiac surgery is still strongly based on the intraoperative administration of unfractionated heparin. The restoring of blood coagulation is conducted by administration of protamine. However, unfractionated heparins often contain a considerable amount of fractionated heparin which cannot be completely neutralized by protamine. The standard determination method of heparin-related anticoagulation and protamine related re-coagulation is the measurement of activated clotting time (ACT). In fact, ACT is unsuitable to assess the real amount of free and protamine-bound heparin in patient's blood, leading to uncertainties in coagulation treatment with clinical consequences.