title: Neutralization of heparin activity.
abstract: Heparin is the mainstay in the treatment and prevention of thrombosis in such diverse clinical settings as venous thromboembolism, acute coronary syndrome, cardiopulmonary bypass, and hemodialysis. However, the major complication of heparin - like that of all anticoagulants - is bleeding. Heparin may need to be reversed in the following settings: clinically significant bleeding; prior to an invasive procedure; at the conclusion of a procedure involving extracorporeal circulation (e.g., cardiopulmonary bypass, dialysis). This chapter discusses protamine sulfate, as well as several other agents that are able to neutralize heparin, including their pharmacological properties, indications, dosing, and efficacy.
authors.affiliation: Department of Medicine, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada. mpai@mcmaster.ca
authors.forename: Menaka
authors.initials: M
authors.lastname: Pai
authors.forename: Mark A
authors.initials: MA
authors.lastname: Crowther
mesh_terms: D015942:Factor VIIa / Q000494:pharmacology*; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D010978:Platelet Factor 4 / Q000494:pharmacology*; D011479:Protamines / Q000494:pharmacology*; D011994:Recombinant Proteins / Q000494:pharmacology
chemical_list: D011479:Protamines; D011994:Recombinant Proteins; D010978:Platelet Factor 4; D006493:Heparin; D015942:Factor VIIa