Reversal of heparin after cardiac surgery: protamine titration using a statistical model.

Abstract

To establish a statistical model for determination of protamine dose in conjunction with cardiopulmonary bypass. Prospective. University hospital. Ninety consecutive cardiac surgical patients. None. A series of clinically oriented variables were introduced into a statistical model for projection of the protamine dose after cardiopulmonary bypass. The following significant predictors were identified using multivariable regression analysis: The patient's body surface area, the administered dose of heparin, heparin clearance, and the preoperative platelet count. The statistical model projected the protamine dose within 3±23 mg of the point-of-care test used as reference. Protamine dosing based on statistical modeling represents an alternative to point-of-care tests.