Partial Reversal of Low Molecular Weight Heparin (PK 10169) Anti-Xa Activity by Protamine Sulfate: In vitro and in vivo Study during Cardiac Surgery with Extracorporeal Circulation
| Autor: | J Swanson, E. Terrier, E. Pelissier, Alain Carpentier, Massonnet-Castel S, M. Samama, P Guibourt, B. Abry, Jaulmes B, L Bara |
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| Rok vydání: | 1986 |
| Předmět: |
Adult
Male Extracorporeal Circulation Protamine sulfate Adolescent medicine.drug_class Low molecular weight heparin In Vitro Techniques Pharmacology In vivo Physiology (medical) medicine Humans Protamines Blood Coagulation medicine.diagnostic_test biology Heparin Chemistry Extracorporeal circulation Heparin Antagonists Hematology Middle Aged Protamine Molecular Weight Coagulation Anesthesia Factor X Factor Xa biology.protein Female Partial Thromboplastin Time medicine.drug Partial thromboplastin time |
| Zdroj: | Pathophysiology of Haemostasis and Thrombosis. 16:139-146 |
| ISSN: | 1424-8840 1424-8832 |
| DOI: | 10.1159/000215283 |
| Popis: | Neutralization of a low molecular weight (LMW) heparin fraction by protamine sulfate was evaluated in vitro and in vivo. Anti-Xa and anti-IIa activities were measured by amidolytic and coagulation methods (activated partial thromboplastin time, APTT). Fifteen patients (4 males and 11 females) underwent surgery with extracorporeal circulation. In vitro, anti-Xa and anti-IIa activities and APTT of unfractionated heparin were neutralized with a protamine/heparin (P/H) gravimetric ratio of 1.6, 1.33 and about 2, respectively. Anti-IIa activity and APTT induced by PK 10169 were completely corrected at a P/H ratio of 1 and 2, respectively, while anti-Xa activity was incompletely neutralized at a ratio of 5. In vivo, in 9 patients who did not receive intravenous protamine sulfate, a good correlation was found between doses of PK 10169 infused, anti-IIa plasma level and blood loss. In 3 patients who were treated prophylactically with protamine, bleeding was normal or only slightly increased. In 3 patients who received protamine because of hemorrhage, mean anti-Xa and anti-IIa were 2.3 and 0.54 U before and 1.32–0.06 U after neutralization. Bleeding was stopped by a second dose of protamine in 1 patient, but blood loss was abnormal in the other patients. However, a correlation between bleeding and anti-Xa or anti-IIa activities was not clearly evident. |
| Databáze: | OpenAIRE |
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