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Reversal of heparin after cardiac surgery: protamine titration using a statistical model
Fredrik Ödling Davidsson1, Daniel Johagen1, Micael Appelblad1
1Department of Surgical & Perioperative Science, Heart Centre Umeå University, Umeå, Sweden.
Objective:
To establish a statistical model for determination of protamine dose in conjunction with cardiopulmonary bypass.
Design:
Prospective.
Setting:
University hospital.
Participants:
Ninety consecutive cardiac surgical patients.
Interventions:
None.
Measurements And Main Results:
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.
Conclusion:
Protamine dosing based on statistical modeling represents an alternative to point-of-care tests.
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