Abstract
Protamine reversal of heparin anticoagulation during cardiovascular surgery may cause severe hypotension and pulmonary hypertension. A novel protamine variant, [+18RGD], has been developed that effectively reverses heparin anticoagulation without toxicity in canine experiments. Heretofore, human studies have not been undertaken. This investigation hypothesized that [+18RGD] would effectively reverse heparin anticoagulation of human blood in vitro. Fifty patients who underwent anticoagulation therapy during vascular surgery had blood sampled at baseline and 30 minutes after receiving heparin (150 IU/kg). Activated clotting times were used to define specific quantities of [+18RGD] or protamine necessary to completely reverse heparin anticoagulation in the blood sample of each patient. These defined amounts of [+18RGD] or protamine were then administered to the heparinized blood samples, and percent reversals of activated partial thromboplastin time, thrombin clotting time, and antifactor Xa/IIa levels were determined. In addition, platelet aggregation assays, as well as platelet and white blood cell counts were performed. [+18RGD] and protamine were equivalent in reversing heparin as assessed by thrombin clotting time, antifactor...Continue Reading
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Feb 15, 2012·Chest·David A GarciaMeyer Michel Samama
Feb 7, 2001·Chest·J HirshJ E Dalen
Sep 6, 2005·Biochemical and Biophysical Research Communications·Jun Feng LiangYekaterina Vaynshteyn
Jul 24, 2008·Chest·Jack HirshJeffrey I Weitz
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