Cardiac Surgery: In Vivo Titration of Protamine
NCT00684450 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 138
Last updated 2011-08-25
Summary
Safe use of cardiopulmonary bypass (CPB) requires massive doses of intravenous unfractionated heparin. At end-CPB, residual heparin is neutralized with intravenous injection of protamine sulfate. This prospective, randomized, controlled study will be conducted in 82 voluntary subjects admitted for elective, first intention, cardiac surgery requiring cardiopulmonary bypass. Each will be randomly assigned to one of two groups. The control group will be submitted to a standard protamine infusion of 1.3mg :100U of the total heparin dose given during bypass. The test group will receive an infusion of protamine (over 15 minutes) until activated clotting time (ACT) values (determined every 3 minutes) depict a plateau, sign that the optimal protamine to heparin ratio has been attained. The investigators hypothesize this new in vivo titration method to be as efficient as the standard protocol (adequacy of heparin neutralization, % heparin rebound, bleeding, and transfusion), and potentially safer by its ability to prevent protamine overdose and its deleterious impact on platelet function.15
Principal Objective
Evaluate a new in vivo method of titration of protamine sulfate.
Secondary Objective
Evaluate the impact of this method on the adequacy of heparin neutralization by measuring:
1. platelet count
2. postoperative bleeding
3. transfusion exposure a
4. incidence of heparin rebound
Conditions
Interventions
- PROCEDURE
-
Titration protamine
10\. Study group: celite ACT will be performed every 3 minutes during protamine infusion until ACT values suggest reach of a plateau (defined as 2 similar ACT values, within 10% variability, and ACT ≤ to 160 seconds.), time at which infusion will be stopped. 2cc of blood is required per ACT test, for a maximum total of 10cc.
- DRUG
-
Standard administration of protamine
1.3 mg of Protamine for 100u héparine
Sponsors & Collaborators
-
Organon
collaborator INDUSTRY -
Montreal Heart Institute
lead OTHER
Principal Investigators
-
Antoine G Rochon · Montreal Heart Institute
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- DOUBLE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2008-06-30
- Primary Completion
- 2011-06-30
- Completion
- 2011-06-30
Countries
- Canada
Study Locations
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