On CPB- Heparin Protocol Survey

Editor’s Note: I received a note from a perfusionist the other day regarding heparin administration, and how it has become regulated at their institution.  It was significant enough- in terms of it’s implications of our ability to manage patients on bypass for me to pass on the concern, and as well- develop a survey to […]

Heparin: Factors Affecting & it’s Effects [Reprint]

HEPARIN ONSET: Maximal at 1 minute past atrial delivery: Measured at radial artery.  Note:  10-20% reduction in svr without affecting c.o. and or h.r. LUNG VS MUCOSAL: Mucosal requires larger doses- but can be reversed with 25-30% less protamine:  greater postoperative blood loss associated with mucosal heparin- speculated to result from lower molecular weight & […]

Heparin: Factors Affecting & it’s Effects

HEPARIN ONSET: Maximal at 1 minute past atrial delivery: Measured at radial artery.  Note:  10-20% reduction in svr without affecting c.o. and or h.r. LUNG VS MUCOSAL: Mucosal requires larger doses- but can be reversed with 25-30% less protamine:  greater postoperative blood loss associated with mucosal heparin- speculated to result from lower molecular weight & […]

Heparin v. Protamine

Calculating Heparin Dosing and Protamine Reversal: Well it was one of those days when we had a TEG representative running TEGS on all of our patient’s for a few days, and I was having a discussion with our Lab manager regarding standards for heparin reversal.  We use the HepCon system, but had been dealing with […]

Heparin (v.1)

HEPARIN   ONSET:   Maximal at 1 minute past atrial delivery: Measured at radial artery.  Note:  10-20% reduction in svr without affecting c.o. and or h.r.   LUNG VS MUCOSAL:   Mucosal requires larger doses- but can be reversed with 25-30% less protamine:  greater postoperative blood loss associated with mucosal heparin- speculated to result from […]

Activated Clotting Time (ACT)

Activated Clotting Time (ACT) The ACT is a standardized measurement of the patients procoagulation or anticoagulation level.  The unit of measurement is the time (in seconds) that is required for an ACT counter to detect the formation of blood clot in a 2-3 milliliter sample of whole blood.  Normal ACT levels range from 100-130 seconds, […]