Heparin reversal protocol

Abstract

protamine administration during cardiopulmonary bypass. However, this method is very cumbersome for routine use in the operating theatre. Three years ago, 1 made an algebraic analysis of the Bull curve in the same way as Dr. Pounder pointed out, and wrote a basic program for a pocket computer. Since then we have used this easy-to-handle and safe system during all the extracorporeal procedures performed in our institution (750 cases a year). To estimate the reliability of this program I compared the baseline ACT (Activated Clotting Time) before heparin and the ACT twenty minutes after protamine administration in a consecutive series of a hundred patients scheduled for elective coronary revascularization. Using a paired Student's t test, I could not demonstrate a statistically significant difference (P = 0.35). To avoid inappropriate conclusions from these analyses, a calculation of statistical power was performed a poster ior i . 4 If a variation in ACT-level of five seconds is assumed to have no clinical relevance, analysis of this sample (100 subjects) showed with 95 per cent confidence that the ACT returned to its baseline level using this