Optimal protamine dosing after cardiopulmonary bypass: The PRODOSE adaptive randomised controlled trial.

ABSTRACT:

Background

The dose of protamine required following cardiopulmonary bypass (CPB) is often determined by the dose of heparin required pre-CPB, expressed as a fixed ratio. Dosing based on mathematical models of heparin clearance is postulated to improve protamine dosing precision and coagulation. We hypothesised that protamine dosing based on a 2-compartment model would improve thromboelastography (TEG) parameters and reduce the dose of protamine administered, relative to a fixed ratio.

Methods and findings

We undertook a 2-stage, adaptive randomised controlled trial, allocating 228 participants to receive protamine dosed according to a mathematical model of heparin clearance or a fixed ratio of 1 mg of protamine for every 100 IU of heparin required to establish anticoagulatio

SUBMITTER: Miles LF 

PROVIDER: S-EPMC8216535 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature