But a study by Van Ryn-McKenna in rabbits showed that protamine neutralized blood loss with both low molecular weight and conventional heparin, though the ex vivo anti factor Xa activity and anti thrombin activity could not be fully neutralized. It is generally considered that protamine sulphate is not a good antidote for bleeding with low molecular weight heparins as it cannot completely neutralize the anti factor Xa activity of low molecular weight heparins. It may be noted that in most cases, only half neutralization of heparin is applied, so the chance of this occurrence should be extremely low.Įffect of protamine sulphate on the effects of low molecular weight heparins 3 But this effect is not seen if the protamine heparin ratio is less than 2.6:1. Protamine sulphate can sometimes paradoxically increase the bleeding, especially after open heart surgery.McLaughlin KE et al have reviewed this aspect and noted that high doses of protamine can cause increased bleeding and impaired platelet function. Paradoxical increase in bleeding with protamine sulphate After a systematic review of literature on this aspect, Nybo M and colleagues concluded that it is quite rare and the occurrence has been documented as 0.69% in prospective studies and 0.19% in retrospective studies. ![]() ![]() It is well known that protamine sulphate can sometimes cause anaphylactic reactions when administered after open heart surgery for reversal of total body heparinization. 1 It is also the treatment of choice in case of significant bleeding with heparin therapy.Īnaphylactic reactions to protamine sulphate Hence protamine sulphate has been widely used to reverse the anticoagulant effects of heparin, especially after open heart surgery. Protamine sulphate is a polypeptide, originally derived from salmon sperm, which binds to unfractionated heparin and neutralizes its effect. ![]() Low molecular weight protamine is under development. It is used when quick reversal of the action of heparin is needed as in case of bleeding or after an open heart surgery. Abstract: Heparin antidote is protamine sulphate.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |