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Related Experiment Video

Updated: Jul 7, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

Published on: February 27, 2026

Focus on thrombin: alternative anticoagulants.

¹Department of Anaesthesiology, University of Auckland, Auckland, New Zealand. a.merry@auckland.ac.nz

Seminars in Cardiothoracic and Vascular Anesthesia

|February 14, 2008

Summary

This summary is machine-generated.

Unfractionated heparin and protamine are standard for cardiopulmonary bypass but have limitations. Direct thrombin inhibitors like bivalirudin offer an alternative, though cost and lack of reversal agents are concerns.

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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

Published on: June 4, 2020

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Last Updated: Jul 7, 2026

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

Published on: February 27, 2026

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

Published on: June 4, 2020

Area of Science:

Cardiovascular Surgery
Pharmacology
Hematology

Background:

Unfractionated heparin and protamine are mainstays in cardiopulmonary bypass (CPB) for cardiac surgery.
Limitations include contraindications, heparin resistance, and potential complications from the inflammatory response during CPB.
Managing anticoagulation in patients unsuitable for heparin is a clinical challenge.

Purpose of the Study:

To review current anticoagulation strategies in cardiac surgery.
To evaluate alternatives to unfractionated heparin and protamine.
To discuss the potential of direct thrombin inhibitors and balanced anticoagulation.

Main Methods:

Literature review of anticoagulation in cardiac surgery.
Analysis of drug properties, efficacy, and safety profiles.
Discussion of clinical implications and future research directions.

Main Results:

Heparin and protamine are effective but have contraindications and resistance issues.
Direct thrombin inhibitors, such as bivalirudin, are viable alternatives but are expensive and lack reversal agents.
Balanced anticoagulation strategies show promise but require further investigation.

Conclusions:

Current anticoagulation options for CPB have trade-offs.
Bivalirudin is a promising alternative to heparin, despite its cost and lack of reversal.
Further research into balanced anticoagulation is needed for optimal CPB management.