This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joel Dunning Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mclaughlin, K. E. Articles by Dunning, J. Search for Related Content PubMed PubMed Citation Articles by Mclaughlin, K. E. Articles by Dunning, J. Related Collections Cardiac - other

In patients post cardiac surgery do high doses of protamine cause increased bleeding?

^a Department of Cardiothoracic Surgery, Wythenshawe, South Moor Road, Manchester, M23 9LT, UK
^b Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK

^* Corresponding author. Tel.: +44-7801548122
joeldunning{at}doctors.org.uk

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether high doses of protamine causes increased bleeding in patients post cardiac surgery. Altogether 268 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that high doses of protamine can cause increased bleeding and impaired platelet function but these effects have never been demonstrated below a ratio of 2.6:1 protamine to heparin.

Key Words: Evidence-based medicine; Thoracic surgery; Protamines; Haemorrhage

This article has been cited by other articles:

				V. G. Nielsen Protamine enhances fibrinolysis by decreasing clot strength: role of tissue factor-initiated thrombin generation. Ann. Thorac. Surg., May 1, 2006; 81(5): 1720 - 1727. [Abstract] [Full Text] [PDF]

				M. A. Smythe, W. E. Dager, and N. M. Patel Managing Complications of Anticoagulant Therapy Journal of Pharmacy Practice, October 1, 2004; 17(5): 327 - 346. [Abstract] [PDF]