Are the Point-of-Care Diagnostics MULTIPLATE and ROTEM Valid in the Setting of High Concentrations of Heparin and Its Reversal With Protamine?

Gertler, Ralph; Wiesner, Gunther; Tassani-Prell, Peter; Braun, S; Martin, Klaus

doi:10.1053/j.jvca.2010.11.020

Cited by 68 publications

(58 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…FIBTEM analysis is insensitive to heparin up to 6 IU ml 21 . 23 Interpretation of measurements at 20 min before CPB removal should consider these effects. The plasma fibrinogen levels observed after surgery corroborate previous data from cardiovascular surgery, 8 24 25 and reflect fibrinogen's role as an acute-phase protein.…”

Section: Discussionmentioning

confidence: 99%

Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Solomon¹,

Hagl²,

Rahe‐Meyer³

2014

Survey of Anesthesiology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Solomon¹,

Hagl²,

Rahe‐Meyer³

2014

Survey of Anesthesiology

View full text Add to dashboard Cite

“…Схожие данные приводят в своих работах M. Mittermayr et al [8] и R. Gertler et al [9], при этом авторы описывают влияние протамина ис-ключительно на внешний путь коагуляционного каскада. В другой работе M. Mittermayr et al [10] приводит данные о влиянии протамина в до-зировке 1,6 ЕД/мл на оба пути коагуляционного каскада.…”

Section: Discussionunclassified

Assessement of Protamine Effect on Thromboelastometry Parameters in Cardiac Surgery Patients in Vitro

Осипенко¹,

Христин²

2016

Novosti Khirurgii

View full text Add to dashboard Cite

Цель. Изучить влияние избытка протамина на показатели гемостаза in vitro и разработать критерии выявления передозировки протамина с использованием тромбоэластометра ROTEM®.Материал и методы. Используя методику простой рандомизации, были сформированы три группы пациентов. В первой группе пациентов в образцы крови добавляли 10 мкл раствора протамина (8,5 ЕД), при этом содержание протамина в исследуемом образце крови составляло 1,57 ЕД/мл. Во второй группе в образцы крови добавляли 10 мкл физиологического раствора хлорида натрия. Третья группа -контроль-ная, в образцы крови не вводили дополнительные препараты.Результаты. В тесте Extem в 1-й группе пациентов наблюдалось увеличение значения CT (104,5 сек), превышающее показатели во 2-й группе пациентов на 37% (65,5 сек), в 3-й группе -на 26% (77,0 сек). В тесте Intem в 1-й группе пациентов обнаружено увеличение длительности показателей CT, CFT, а также изменение величины угла α по сравнению с пациентами 2-й и 3-й групп. Значения CT, CFT в 1-й группе превышали показатели во 2-й группе на 42% (210,0 сек) и 41% (71,5 сек); угол α в 1-й группе (67,0º) был меньше на 12% в сравнении с 2-й группой (75,5º). Значения CT, CFT в 1-й группе превышали показатели в 3-й группе на 50% (182,5 сек) и 23% (94,0 сек); угол α в 1-й группе был меньше на 7% в сравнении с 3-й группой (72,0º).Заключение. Протамин in vitro в концентрации 1,57 ЕД/мл обладает выраженным гипокоагулянтным эффектом, что проявляется характерными изменениями в тромбоэластометрии ROTEM®. Ключевые слова: кровь, антикоагулянты, гепарин, протамин, методы измерения, тромбоэластометрия, Rotem®Objectives. To study the effects of protamine overdose on hemostatic parameters in vitro and to work out the criteria of protamine overdose using thromboelastometer ROTEM®.Methods. Three groups of patients were formed randomly. The 10 µl of protamine solution (8,5 U) were added to the blood samples of the first group of patients. The concentration of protamine in the blood of the test sample was 1,57 U/ml. 10µl of sodium chloride solution were administrated to the blood samples of the second group. The third group (the control one) -no any additional drugs were introduced into the blood samples.Results. In the first group of patients by Extem test the increase of the CT (104,5 s) was observed, which was higher by 37% (65,5 s) in the second group of patients and by 26% (77,0 s) in the third group. In the first group of patients by Intem test the increase of the CT values and CFT and also α angle change was determined compared with the second and third groups. The values of CT, CFT in the first group were higher than in the second group by 42% (210,0 s) and by 41% (71,5 s); the α angle in the first group (67,0º) was lower by 12% compared to the second group (75,5º). The values of CT, CFT in the first group were higher than in the third group by 50% (182,5 s) and by 23% (94,0 s); the α angle in the first group was lower by 7% compared to the third group (72,0º).Conclusion. Protamine at a concentration of 1.57 U/ml has a strong hypocoagu...

show abstract

“…The effect of protamine on platelet receptors stimulated by ADP and TRAP has been studied before but the results are not consistent and varies between receptors. Lindblad et al 36 was not able to find a relation between protamine and platelet activation whereas Gertler et al 6 found that both ADP and TRAP induced platelet activation was reduced by protamine. Griffin et al 4 suggested that protamine alone or in excess of heparin have similar antiplatelet effects and that excessive protamine directly contributes to platelet dysfunction.…”

Section: The Ringers Chase Technique (Rc)mentioning

confidence: 96%

“…Previous studies has suggested that the interaction between the heparin-protamine complex and platelets can affect platelet aggregation 128 . Platelet function could be affected at different heparin-protamine ratios 6 , and excessive protamine has been suggested to contribute to the dysfunction 34,129 . How and to what extent protamine itself affects platelet aggregation is not very well studied.…”

Section: Hypothesismentioning

confidence: 99%

“…The effect is reversed with protamine sulfate after weaning from CPB 1 . Protamine and the heparinprotamine complex has been suggested to impair platelet aggregation [4][5][6] but the mechanism is incompletely understood. Increased knowledge about protamine and a possible effect on platelet aggregation could increase the understanding of hemostatic problems after CPB and improve the treatment of the patient.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemostatic function and inflammatory activation after weaning from cardio pulmonary bypass

Olsson¹

2018

Linköping University Medical Dissertations

View full text Add to dashboard Cite

Are the Point-of-Care Diagnostics MULTIPLATE and ROTEM Valid in the Setting of High Concentrations of Heparin and Its Reversal With Protamine?

Cited by 68 publications

References 39 publications

Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Time Course of Haemostatic Effects of Fibrinogen Concentrate Administration in Aortic Surgery

Assessement of Protamine Effect on Thromboelastometry Parameters in Cardiac Surgery Patients in Vitro

Hemostatic function and inflammatory activation after weaning from cardio pulmonary bypass

Contact Info

Product

Resources

About