Lower Doses of Protamine Linked to Shorter Clotting Times

Lower doses of the drug protamine to reverse heparin after cardiopulmonary bypass are associated with shorter clotting times than traditional doses, according to a study reported in Anesthesiology News.

The study was conducted by researchers at the University of Florida in Gainesville. "Some anesthesia providers at our institution were noticing that when giving less than traditional protamine doses for heparin reversal, the post-protamine activated clotting time values were close to baseline values, or sometimes even lower," said Adrienne B. Warrick, MD, an anesthesiologist resident and researcher in the study.

Dr. Warrick and her colleagues reviewed the charts of 68 patients who underwent cardiac bypass surgery at the University of Florida between July 2009 and July 2010. Half received the normal dose of 1 to 1.3 mg of protamine per 100 units of heparin; a low-dose group received 0.5 to 0.7 mg of protamine per 100 units of heparin.

Patients in the low-dose group had lower activated clotting values. Dr. Warrick said that the number of participants was a limitation of the study, but the findings suggest that a lower dose of protamine is at least as effective and safe as a normal dose of protamine for heparin reversal.

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