Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue

  • Ku, Min Jung (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital) ;
  • Kim, Su Wan (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital) ;
  • Lee, Seogjae (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital) ;
  • Chang, Jee Won (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital) ;
  • Lee, Jonggeun (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital)
  • Received : 2019.07.23
  • Accepted : 2020.01.06
  • Published : 2020.10.30
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Abstract

Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31). Results: Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26℃ were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A. Conclusion: Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.

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References

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